Gastroenterology Report最新文献_第4页

Coexisting steatotic liver disease is not associated with long-term liver-related events in patients with chronic hepatitis B. 慢性乙型肝炎患者共存的脂肪变性肝病与长期肝脏相关事件无关。

IF 3.8 3区医学

Gastroenterology Report Pub Date : 2025-02-12 eCollection Date: 2025-01-01 DOI: 10.1093/gastro/goaf013

Navavee Uman, Apichat Kaewdech, Pimsiri Sripongpun, Naichaya Chamroonkul, Teerha Piratvisuth

{"title":"Coexisting steatotic liver disease is not associated with long-term liver-related events in patients with chronic hepatitis B.","authors":"Navavee Uman, Apichat Kaewdech, Pimsiri Sripongpun, Naichaya Chamroonkul, Teerha Piratvisuth","doi":"10.1093/gastro/goaf013","DOIUrl":"10.1093/gastro/goaf013","url":null,"abstract":"Steatotic liver disease (SLD) is an emerging liver disease, whereas chronic viral hepatitis is the renowned cause of chronic liver disease leading to cirrhosis and hepatocellular carcinoma (HCC). The impact of coexisting SLD in chronic hepatitis B (CHB) on liver-related events (LREs) in the long term is still debated. This study aims to compare all-cause mortality and LRE between CHB patients with and without SLD. This retrospective study included CHB patients who underwent transient elastography between 2014 and 2021 at a tertiary-care hospital. Exclusion criteria were those without controlled attenuated parameter (CAP) results, interquartile range/median of liver stiffness measurement (LSM) > 30%, follow-up time < 6 months, and without hepatitis B virus DNA data during follow-up. SLD was defined as CAP ≥ 248 dB/m, significant liver fibrosis (SF) as LSM ≥ 7 kPa, and cirrhosis as LSM ≥11 kPa or imaging evidence. LRE was defined as the development of HCC and/or cirrhosis complications. Among 532 patients (median follow-up 4.3 years), SLD was present in 161 (30.2%) patients, SF was found in 186 (34.5%) patients, and 104 (19.6%) patients had cirrhosis at baseline. SF was insignificantly more common in SLD patients (40.1% vs 32.4%, P = 0.068). Long-term outcomes showed SF, not SLD, was independently associated with higher LRE development with an adjusted HR of 13.85 (95% confidence interval [CI]: 3.06-62.76, P < 0.001), while the adjusted HR of SLD was 0.49 (95% CI: 0.16-1.53, P = 0.22). In conclusion, SLD commonly coexists with CHB patients. CHB patients with SLD were more likely to have SF at baseline, albeit not significantly. Long-term HCC and cirrhosis complications development are associated with SF but not SLD status.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf013"},"PeriodicalIF":3.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gaps and disparities in the treatment of chronic hepatitis B infection in the USA. 美国慢性乙型肝炎感染治疗的差距和差异。

IF 3.8 3区医学

Gastroenterology Report Pub Date : 2025-02-06 eCollection Date: 2025-01-01 DOI: 10.1093/gastro/goaf016

Robert J Wong

{"title":"Gaps and disparities in the treatment of chronic hepatitis B infection in the USA.","authors":"Robert J Wong","doi":"10.1093/gastro/goaf016","DOIUrl":"10.1093/gastro/goaf016","url":null,"abstract":"Chronic hepatitis B (CHB) infection affects nearly 300 million individuals worldwide and is a leading cause of hepatocellular carcinoma and liver-related mortality. However, major gaps in the CHB cascade of care persist, with the majority of individuals with CHB not diagnosed and not linked to care and treatment. Even among individuals with known CHB, existing studies report on major gaps and disparities in timely linkage to care and timely access to CHB therapies. While the momentum to expand and simplify CHB treatment guidelines is promising, access to treatment still relies on individuals being effectively engaged in clinical care and liver disease monitoring. The contributing factors to the observed gaps and disparities in the CHB cascade of care are complex and multifactorial, and there is no one-size-fits-all solution than can be easily applied across all global regions. However, any serious approach towards addressing the existing gaps in the CHB cascade of care to improve patient outcomes requires a concerted investment from healthcare institutions, governments, policymakers, and industry partners to provide the necessary resources to be able to achieve this goal. Anything less than a comprehensive and collaborative approach that engages all stakeholders to invest effort and resources into tackling the global epidemic of CHB will continue to fall short in making progress towards global viral hepatitis elimination goals.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf016"},"PeriodicalIF":3.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Odevixibat as a possible rescue therapy in a pediatric patient with vanishing bile ducts syndrome associated with ethosuximide-induced DILI-DRESS. 奥维西巴作为一种可能的抢救治疗，用于治疗与乙氧苏亚胺诱导的DILI-DRESS相关的胆管消失综合征的儿童患者。

IF 3.8 3区医学

Gastroenterology Report Pub Date : 2025-02-06 eCollection Date: 2025-01-01 DOI: 10.1093/gastro/goaf014

Silvio Veraldi, Luca Della Volpe, Valerio Cecinati, Paola Francalanci, Giuseppe Maggiore, Andrea Pietrobattista

引用次数: 0

The safety and feasibility of a novel cap-assisted endoscopic resection device for rectal tissue resection: a pilot study (with videos). 一种用于直肠组织切除的新型帽辅助内镜切除装置的安全性和可行性：一项初步研究（带视频）。

IF 3.8 3区医学

Gastroenterology Report Pub Date : 2025-01-30 eCollection Date: 2025-01-01 DOI: 10.1093/gastro/goaf003

Xuelian Gao, Jing Wang, Jiaming He, Panpan Liu, Haiyan Hu, Jun He, Side Liu, Yue Li

引用次数: 0

Efficacy of vagus nerve stimulation in gastrointestinal disorders: a systematic review. 迷走神经刺激治疗胃肠道疾病的疗效：系统综述。

IF 3.8 3区医学

Gastroenterology Report Pub Date : 2025-01-26 eCollection Date: 2025-01-01 DOI: 10.1093/gastro/goaf009

Fleur Veldman, Kimberly Hawinkels, Daniel Keszthelyi

{"title":"Efficacy of vagus nerve stimulation in gastrointestinal disorders: a systematic review.","authors":"Fleur Veldman, Kimberly Hawinkels, Daniel Keszthelyi","doi":"10.1093/gastro/goaf009","DOIUrl":"10.1093/gastro/goaf009","url":null,"abstract":"Dysfunction of the vagus nerve has been suggested as a contributing factor in various gastrointestinal disorders, prompting interest in vagus nerve stimulation (VNS) as a non-pharmacological therapy. We performed a systematic review to determine the efficacy of invasive and non-invasive VNS in gastrointestinal disorders, including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation, gastroesophageal reflux disease, and gastroparesis. We applied a systematic search of the literature in the PubMed, Embase, Web of Science, and Cochrane Library databases in order to identify studies comparing VNS with an adequate control condition (sham stimulation) in patients with gastrointestinal disorders. The primary outcome was adequate symptom relief. Methodological quality was evaluated using the revised Cochrane risk-of-bias tool. Meta-analyses were not performed due to study heterogeneity. Seven randomized controlled trials investigating non-invasive VNS were included, with a total of 644 patients: FD (n = 426), IBD (n = 22), IBS (n = 92), and abdominal pain-related functional gastrointestinal disorder (n = 104), with a mean age ranging from 15 to 65 years. Non-invasive VNS significantly improved symptoms across all subsets of patients, as measured differently according to disease type, compared with sham stimulation. Adverse events, if reported, were low, with no serious complications. Putative mechanisms of action were assumed to be related to anti-inflammatory and anti-nociceptive effects. Non-invasive VNS holds promise as a safe therapy for diverse gastrointestinal disorders. However, these findings are derived from studies with small sample sizes and provide preliminary insights. Further research is warranted to define its exact position within the therapeutic arsenal.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf009"},"PeriodicalIF":3.8,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of intrahepatic cholangiocarcinoma: a review for clinicians. 肝内胆管癌的治疗：临床医生综述。

IF 3.8 3区医学

Gastroenterology Report Pub Date : 2025-01-26 eCollection Date: 2025-01-01 DOI: 10.1093/gastro/goaf005

Matteo Colangelo, Marcello Di Martino, Michela Anna Polidoro, Laura Forti, Nastassja Tober, Alessandra Gennari, Nico Pagano, Matteo Donadon

{"title":"Management of intrahepatic cholangiocarcinoma: a review for clinicians.","authors":"Matteo Colangelo, Marcello Di Martino, Michela Anna Polidoro, Laura Forti, Nastassja Tober, Alessandra Gennari, Nico Pagano, Matteo Donadon","doi":"10.1093/gastro/goaf005","DOIUrl":"10.1093/gastro/goaf005","url":null,"abstract":"Intrahepatic cholangiocarcinoma (iCCA) is an aggressive liver malignancy that arises from second-order biliary epithelial cells. Its incidence is gradually increasing worldwide. Well-known risk factors have been described, although in many cases, they are not identifiable. Treatment options are continuously expanding, but the prognosis of iCCA remains dismal. R0 liver resection remains the only curative treatment, but only a limited number of patients can benefit from it. Frequently, major hepatectomies are needed to completely remove the tumour. This could contraindicate surgery or increase postoperative morbidity in patients with chronic liver disease and small remnant liver volume. In cases of anticipated inadequate future liver remnant, regenerative techniques may be used to expand resectability. The role and extent of lymphadenectomy in iCCA are still matters of debate. Improvements in iCCA diagnosis and better understanding of genetic profiles might lead to optimized surgical approaches and drug therapies. The role of neoadjuvant and adjuvant therapies is broadening, gaining more and more acceptance in clinical practice. Combining surgery with locoregional therapies and novel drugs, such as checkpoint-inhibitors and molecular-targeted molecules, might improve treatment options and survival rates. Liver transplantation, after very poor initial results, is now receiving attention for the treatment of patients with unresectable very early iCCA (i.e. <2 cm) in cirrhotic livers, showing survival outcomes comparable to those of hepatocellular carcinoma. Ongoing prospective protocols are testing the efficacy of liver transplantation for patients with unresectable, advanced tumours confined to the liver, with sustained response to neoadjuvant treatment. In such a continuously changing landscape, the aim of our work is to review the state-of-the-art in the surgical and medical treatment of iCCA.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf005"},"PeriodicalIF":3.8,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From chelation to transplantation: lessons from a progressive familial intrahepatic cholestasis type 3 case initially managed as Wilson's disease. 从螯合到移植：从进展性家族性肝内胆汁淤积3型病例的经验教训，最初处理为威尔逊病。

IF 3.8 3区医学

Gastroenterology Report Pub Date : 2025-01-25 eCollection Date: 2025-01-01 DOI: 10.1093/gastro/goaf017

Ali Emre Bardak, Tuğba Kalaycı, Bilger Çavuş, Aslı Çifçibaşı Örmeci, Kadir Demir

引用次数: 0

Resolution of cuffitis after removal surgical staple from ileal pouch-anal anastomosis. 回肠袋-肛管吻合术去除手术钉后鼻炎的解决。

IF 3.8 3区医学

Gastroenterology Report Pub Date : 2025-01-20 eCollection Date: 2025-01-01 DOI: 10.1093/gastro/goaf002

Bo Shen, Huaibin M Ko, Ravi Kiran, James Church

引用次数: 0

Preliminary results of a novel sphincter-sparing technique-fistula occlusion with the internal sphincter flap (FOISF)-for high complex anal fistulas. 一种新颖的保留括约肌技术-内括约肌瓣（FOISF）瘘封堵-治疗高度复杂肛瘘的初步结果。

IF 3.8 3区医学

Gastroenterology Report Pub Date : 2025-01-18 eCollection Date: 2025-01-01 DOI: 10.1093/gastro/goaf006

Dandan Huang, Ning Wang, Yiping Li, Donglin Ren, Yong Yang, Kaikai Wei, Yanzhu Li, Zhimin Liu

{"title":"Preliminary results of a novel sphincter-sparing technique-fistula occlusion with the internal sphincter flap (FOISF)-for high complex anal fistulas.","authors":"Dandan Huang, Ning Wang, Yiping Li, Donglin Ren, Yong Yang, Kaikai Wei, Yanzhu Li, Zhimin Liu","doi":"10.1093/gastro/goaf006","DOIUrl":"10.1093/gastro/goaf006","url":null,"abstract":"Background and aim: High complex anal fistula is a clinical challenge for proctologists and a nightmare for patients. Although the sphincter-sparing approach seems an ideal surgical intervention, there remains room for improvement in treatment efficacy. Herein, we introduce an enhanced sphincter-sparing approach, namely the fistula occlusion with the internal sphincter flap (FOISF), for treating high complex anal fistulas.Methods: This study evaluated 15 patients with high complex anal fistulas who underwent FOISF between October 2021 and December 2022 in the Sixth Affiliated Hospital, Sun Yat-sen University (Guangzhou, P. R. China). Data on success rates, anal function, and various surgical characteristics were subjected to rigorous analysis.Results: All patients underwent the FOISF procedure, with a median operation time of 53 min. Fourteen patients achieved primary intention healing, while one patient healed by second intention. No recurrence was observed over a follow-up period of 14-30 months. All patients exhibited satisfactory anal continence, with no statistically significant difference observed between preoperative and postoperative Wexner scores (P = 0.331). A significant improvement in the quality of life was observed when compared with the preoperative assessment (P < 0.001).Conclusion: The preliminary results of the FOISF procedure present an effective approach to treat high complex anal fistula.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf006"},"PeriodicalIF":3.8,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Technical challenge of EUS-guided pancreatic duct drainage with gastroscopy for pediatric pancreaticojejunostomy stricture. 内镜引导下胰管引流治疗小儿胰空肠吻合术狭窄的技术挑战。

IF 3.8 3区医学

Gastroenterology Report Pub Date : 2025-01-11 eCollection Date: 2025-01-01 DOI: 10.1093/gastro/goae109

Longwei Fang, Zhen Liang, Kun Lian, Senlin Hou, Lichao Zhang

引用次数: 0