世界胃肠病理生理学杂志(电子版)(英文版)最新文献

{"title":"Comparison of gastric emptying of solid and semi-solid meals using real-time ultrasonography in healthy Sri Lankan adults.","authors":"Lakmali Amarasiri, Minerva de Silva, Hithanadura Janaka de Silva, Niranga M Devanarayana","doi":"10.4291/wjgp.v16.i3.106482","DOIUrl":"10.4291/wjgp.v16.i3.106482","url":null,"abstract":"<p><strong>Background: </strong>Routine assessment of solid gastric emptying is challenging due to the prolonged test duration and complex meal preparation. Replacing solid test meals with easily prepared, commercially available semisolid meals and shortening the test duration can significantly enhance the feasibility and practicality of gastric emptying evaluations.</p><p><strong>Aim: </strong>To compare the gastric emptying and antral motility of solid <i>vs</i> semi-solid meals of similar volume and nutritional consistency, and to assess the feasibility of meal substitution and reduction in test duration during the solid gastric emptying assessment.</p><p><strong>Methods: </strong>Thirty healthy volunteers (17 males, age: 29.4 ± 6.0 years, body mass index: 23.4 ± 2.94 and 13 females, age: 37.2 ± 11.9 years, body mass index: 22.9 ± 4.34) underwent gastric emptying by real-time ultrasonography after a solid meal and a comparable commercially prepared semi-solid meal (each meal, total calorie 350 kcal, carbohydrates 60%, fat 30% and proteins 10%), on separate dates 1 week apart. The gastric antral area was measured at 5 minutes, 15 minutes, 30 minutes, 45 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes, 180 minutes, 210 minutes, and 240 minutes post-ingestion using a previously validated technique and compared between meals.</p><p><strong>Results: </strong>Mean and median antral areas, gastric emptying rates, gastric residual ratios, and motility index at each time point were almost similar between meals for up to 3 hours. At the end of 4 hours, the mean emptied percentage of the semisolid meal and solid meal was 81.1% and 70.6%, respectively. The emptying rate of the semisolid meal at 90 minutes significantly correlated with that of 240 minutes. There was no correlation between the solid meal emptying rates at 90 minutes and 240 minutes.</p><p><strong>Conclusion: </strong>Gastric emptying, residual antral cross-sectional area and antral motility of a semisolid meal are almost similar to that of a solid meal of the same nutritional value until three hours post-ingestion. A semisolid test meal can effectively substitute a solid test meal during ultrasound assessment of gastric emptying, without compromising the validity of the results. Additionally, the ease of preparation and administration of semisolid meals enhances the overall feasibility of gastric emptying assessments.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"16 3","pages":"106482"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal retention on modified barium swallow study: Limited predictive value for true esophageal pathology.","authors":"Sabrina Lauren Chen, Diana Partida, Connie Wang, Priya Kathpalia","doi":"10.4291/wjgp.v16.i3.108900","DOIUrl":"10.4291/wjgp.v16.i3.108900","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia is a prevalent condition affecting over 15 million adults in the United States, posing serious health risks and contributing to rising healthcare costs. Early evaluation, often initiated by speech-language pathologists (SLPs) using the modified barium swallow study (MBSS), is essential to identify underlying causes. Although SLPs have traditionally focused on oropharyngeal swallowing, emerging guidelines now support esophageal visualization during MBSS. However, standardized practices and consensus remain limited. This study hypothesizes that incidental esophageal retention observed on MBSS do not correlate with clinically relevant esophageal dysphagia.</p><p><strong>Aim: </strong>To assess whether abnormal esophageal retention on MBSS predicts clinically relevant esophageal disease based on subsequent diagnostic studies.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with abnormal MBSS findings who were referred to gastroenterology (GI) for dysphagia between September 2017 and August 2023. Patients with prior foregut/head/neck surgery or without esophageal phase evaluation on MBSS were excluded. Baseline characteristics, MBSS findings and results from subsequent esophageal studies within one year of MBSS were analyzed. Patient profiles were evaluated by two raters to determine whether subjects had confirmed esophageal pathology. <i>χ</i> ² tests compared MBSS findings with esophageal study abnormalities.</p><p><strong>Results: </strong>Of 199 referrals to GI with abnormal MBSS findings, 122 patients had subsequent esophageal studies or GI clinic follow-up. Esophagram was performed in 64 patients, esophagogastroduodenoscopy (EGD) in 53 patients, manometry in 31 patients, and anti-reflux monitoring in 11 patients. Confirmed esophageal pathology was identified in 27 patients. No significant association was observed between esophageal retention on MBSS and confirmed esophageal pathology (<i>χ</i> ² = 0.30, <i>P</i> value = 0.58) or with abnormal pathology on EGD, esophagram, manometry or anti-reflux testing in both unadjusted and adjusted analyses.</p><p><strong>Conclusion: </strong>Esophageal retention on MBSS does not reliably predict esophageal pathology and is not an effective standalone screening tool for esophageal dysphagia, though it may offer limited theoretical insights.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"16 3","pages":"108900"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatobiliary fascioliasis: A neglected re-emerging threat, its diagnostic and management challenges.","authors":"Alaa Ismail, Mohamed Ayman Abdelsalam, Mustafa H Shahin, Yusuf Ahmed, Ibrahim Halil Bahcecioglu, Mehmet Yalniz, Ahmed Tawheed","doi":"10.4291/wjgp.v16.i2.107599","DOIUrl":"10.4291/wjgp.v16.i2.107599","url":null,"abstract":"<p><p>Hepatobiliary fascioliasis is a neglected but re-emerging parasitic disease caused by <i>Fasciola hepatica</i>. Humans become infected by consuming contaminated water or aquatic plants, allowing the parasite to enter the digestive tract. From there, immature flukes penetrate the intestinal wall and migrate through the liver, triggering inflammation, fibrosis, and biliary complications. Over time, this can lead to cholangitis, biliary obstruction, and long-term liver damage. Due to its vague clinical symptoms and the limitations of current diagnostic methods, fascioliasis could be easily missed. Stool analysis is still used to detect eggs in diagnosis. However, this method is unreliable due to the inconsistency of the egg shedding. Also, serological tests are often linked to false positives due to the cross-reactions with other parasites. Imaging techniques such as ultrasound, computed tomography, and magnetic resonance imaging can reveal its complications, especially in the biliary phase, yet this is not specific. Molecular tests like polymerase chain reaction (PCR) have higher sensitivity and specificity and allow earlier diagnosis, but they are still not widely available, especially in low-resource settings. Triclabendazole is the only recommended medical treatment, yet it is not widely available. In addition, the emerging reports of resistance represent a potential threat in managing this infection. Other modalities could be needed in addition to triclabendazole, such as endoscopic retrograde cholangiopancreatography in patients with biliary complications. All the previously mentioned challenges necessitate the urgent need to make the newly developed diagnostic methods, such as PCR, available, especially in areas where fascioliasis is endemic. Additionally, new medical treatments and therapeutic options should be considered to provide a second line of management, particularly in light of emerging reports of resistance.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"16 2","pages":"107599"},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a risk prediction model for gastroesophageal reflux disease: Gastroesophageal Reflux Disease Risk Scoring System.","authors":"Shanmathi Subramanian, Umashri Sundararaju, Hamrish Kumar Rajakumar, Varsha Coimbatore Sathyabal, Arun Murugan, Pavithra Gnanavel, Kasinathan Sathishkumar","doi":"10.4291/wjgp.v16.i2.107994","DOIUrl":"10.4291/wjgp.v16.i2.107994","url":null,"abstract":"<p><strong>Background: </strong>The rising global prevalence of gastroesophageal reflux disease (GERD) has been closely linked to lifestyle changes driven by globalization. GERD imposes a substantial public health burden, affecting quality of life and leading to potential complications. Early intervention through lifestyle modification can prevent disease onset; however, there is a lack of effective risk prediction models that emphasize primary prevention.</p><p><strong>Aim: </strong>To develop and validate a GERD Risk Scoring System (GRSS) aimed at identifying high-risk individuals and promoting primary prevention strategies.</p><p><strong>Methods: </strong>A 45-item questionnaire encompassing major lifestyle and demographic risk factors was developed and validated. It was administered to healthy controls and GERD patients. Two regression models-one using continuous variables and another using categorized variables-were used to develop a computational prediction equation and a clinically applicable scoring scale. An independent validation cohort of 355 participants was used to assess model performance in terms of discrimination (C-index), calibration, sensitivity, specificity, internal consistency (Cronbach's alpha), and test-retest reliability (intraclass correlation coefficient, Bland-Altman analysis).</p><p><strong>Results: </strong>Significant associations were observed between GERD and key lifestyle factors. The derived GRSS equation and scoring scale demonstrated strong discriminative ability, with high sensitivity and specificity. The scoring system exhibited excellent internal consistency (Cronbach's alpha) and strong test-retest reliability. The C-index indicated excellent predictive accuracy in both derivation and validation cohorts.</p><p><strong>Conclusion: </strong>GRSS offers a novel and validated approach to GERD risk prediction, combining a robust equation for digital applications and a practical scale for clinical use. Its ability to accurately identify at-risk individuals supports a paradigm shift toward primary prevention, underscoring its significance in addressing the growing burden of GERD at the population level.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"16 2","pages":"107994"},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary biliary cholangitis: A historical perspective from xanthomatous lesions to modern molecular biology.","authors":"Vasiliy Ivanovich Reshetnyak, Elena Vladimirovna Vinnitskaya, Igor Veniaminovich Maev","doi":"10.4291/wjgp.v16.i2.107347","DOIUrl":"10.4291/wjgp.v16.i2.107347","url":null,"abstract":"<p><p>Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease characterized by damage and loss of the epithelial lining of small intrahepatic bile ducts, leading to ductopenia and cholestasis. In advanced stages, this process results in cirrhosis and liver failure. The disease belongs to cholangiopathies. The review addressed historical questions concerning: The history of the first mention of this disease; how its nomenclature was formed; when specific serological tests were discovered and their importance in the diagnosis of PBC; the history of ursodeoxycholic and other bile acids for the treatment of PBC; and the significance of modern data on impaired bicarbonate production by cholangiocytes in the pathogenesis of PBC.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"16 2","pages":"107347"},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic neuroendocrine tumors: A case-based evidence review.","authors":"Naveena Rikhraj, Cornelius J Fernandez, Vanishri Ganakumar, Joseph M Pappachan","doi":"10.4291/wjgp.v16.i2.107265","DOIUrl":"10.4291/wjgp.v16.i2.107265","url":null,"abstract":"<p><p>Pancreatic neuroendocrine tumors (pNETs) are rare, presenting significant challenges in timely diagnosis and subsequent treatment. The clinical and pathobiological behavior of these tumors varies significantly, making follow-up and therapeutic approaches challenging for clinicians. Although the majority of these neoplasms are hormonally inactive, some can be associated with endocrine dysfunction. Very rarely, a nonfunctional tumor can later become hormonally active, further complicating prognostication and management. Depending on the character of the disease, clinical picture and prognosis, different treatment modalities are instituted with varying effectivities. We recently came across a unique case of nonfunctioning malignant pNET at an advanced stage, metastatic disease upon diagnosis, managed medically with somatostatin analog therapy (Octreotide) and targeted therapy (Everolimus) with stable disease for 40 months that subsequently turned out to become functional (insulinoma). With the aid of this unique case, we update the current clinical, diagnostic and therapeutic approach to pNETs in this evidence-based review.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"16 2","pages":"107265"},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiology of anastomotic stricture following rectal anastomosis: Insights into mechanisms, risk factors, and preventive strategies.","authors":"Ahmet Yavuz, Hikmet Pehlevan-Özel, Mesut Tez","doi":"10.4291/wjgp.v16.i2.107492","DOIUrl":"10.4291/wjgp.v16.i2.107492","url":null,"abstract":"<p><p>Anastomotic stricture (AS) remains a significant complication following rectal anastomosis, with an incidence ranging from 5% to 30% depending on surgical technique, patient factors, and postoperative management. This review aims to elucidate the pathophysiology of AS, exploring the underlying mechanisms that contribute to its development, including ischemia, inflammation, fibrosis, and impaired healing. Key risk factors such as low anterior resection, preoperative radiotherapy, and anastomotic leakage are critically analyzed based on recent clinical and experimental evidence. The article synthesizes current insights into the molecular and cellular processes, such as excessive collagen deposition and myofibroblast activation, that drive stricture formation. Furthermore, preventive strategies, including optimized surgical techniques (<i>e.g.</i>, tension-free anastomosis), enhanced perioperative care, and emerging therapeutic interventions (<i>e.g.</i>, anti-fibrotic agents), are discussed with an emphasis on translating research into clinical practice. By integrating findings from preclinical studies, clinical trials, and meta-analyses, this review highlights gaps in current knowledge and proposes future directions for research, such as the role of personalized medicine and novel biomaterials in reducing AS incidence. This comprehensive analysis underscores the need for a multidisciplinary approach to mitigate this challenging postoperative complication.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"16 2","pages":"107492"},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on molecular pathogenesis of <i>Helicobacter pylori</i>-induced gastric cancer.","authors":"Yasir Raza, Muhammed Mubarak, Muhammad Yousuf Memon, Mohammed Saud Alsulaimi","doi":"10.4291/wjgp.v16.i2.107052","DOIUrl":"10.4291/wjgp.v16.i2.107052","url":null,"abstract":"<p><p><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is one of the most prevalent bacterial infections affecting mankind. About half of the world's population is infected with it. It causes several upper gastrointestinal diseases, including gastric cancer (GC). It has been identified as a major risk factor for GC. GC is one of the most common cancers affecting humans and the third leading cause of cancer-related deaths worldwide. <i>H. pylori</i> infection causes an inflammatory response that progresses through a series of intermediary stages of precancerous lesions (gastritis, atrophy, intestinal metaplasia, and dysplasia) to the final development of GC. Among infected individuals, approximately 10% develop severe gastric lesions such as peptic ulcer disease, 1%-3% progress to GC, and 0.1% develop mucosa-associated lymphoid tissue followed by the development of lymphoma. The bacterium has many virulence factors, including cytotoxin-associated gene A, vacuolating cytotoxin A, and the different outer membrane proteins that cause cancer by different mechanisms. These virulence factors activate cell signaling pathways such as PI3-kinase/Akt, JAK/STAT, Ras, Raf, and ERK signaling that control cell proliferation. Uncontrolled proliferation can lead to cancer. In addition, the repair of DNA damage may also be impaired by <i>H. pylori</i> infection. Reduced DNA repair in combination with increased DNA damage can result in carcinogenic mutations. The accurate identification of pathogenetic pathways is imperative for the development of targeted diagnostic markers and personalized treatments. This scoping review aims to update the readers on the role of <i>H. pylori</i> in the development of GC. It will focus on the molecular mechanisms underpinning gastric carcinogenesis in <i>H. pylori</i> infection. It will highlight the interaction between bacterial virulence factors and host cellular pathways, providing insights into potential therapeutic targets and preventive strategies.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"16 2","pages":"107052"},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of biological therapies in autoimmune hepatitis: A case-based systematic review.","authors":"Haifa Eldew, Jonathan Soldera","doi":"10.4291/wjgp.v16.i1.101481","DOIUrl":"10.4291/wjgp.v16.i1.101481","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune hepatitis (AIH) is typically treated with immunomodulators and steroids. However, some patients are refractory to these treatments, necessitating alternative approaches. Biological therapies have recently been explored for these difficult cases.</p><p><strong>Aim: </strong>To assess the efficacy and safety of biologics in AIH, focusing on patients unresponsive to standard treatments and evaluating outcomes such as serological markers and histological remission.</p><p><strong>Methods: </strong>A case-based systematic review was performed following the PRISMA protocol to evaluate the efficacy and safety of biological therapies in AIH. The primary focus was on serological improvement and histological remission. The secondary focus was on assessing therapy safety and additional outcomes. A standardized search command was applied to MEDLINE, EMBASE, and Cochrane Library databases to identify relevant studies. Inclusion criteria encompassed adult AIH patients treated with biologics. Data were analyzed based on demographics, prior treatments, and therapy-related outcomes. A narrative synthesis was employed to address biases and provide a comprehensive overview of the evidence.</p><p><strong>Results: </strong>A total of 352 studies were reviewed, with 30 selected for detailed analysis. Key findings revealed that Belimumab led to a favourable response in five out of eight AIH patients across two studies. Rituximab demonstrated high efficacy, with 41 out of 45 patients showing significant improvement across six studies. Basiliximab was assessed in a single study, where the sole patient treated experienced a beneficial outcome. Additionally, a notable number of AIH cases were induced by anti-tumor necrosis factor (TNF) medications, including 16 cases associated with infliximab and four cases with adalimumab. All these cases showed improvement upon withdrawal of the biologic agent.</p><p><strong>Conclusion: </strong>Belimumab and Rituximab show promise as effective alternatives for managing refractory AIH, demonstrating significant improvements in clinical outcomes and liver function. However, the variability in patient responses to different therapies highlights the need for personalized treatment strategies. The risk of AIH induced by anti-TNF therapies underscores the need for vigilant monitoring and prompt symptom recognition. These findings support the incorporation of biologic agents into AIH treatment protocols, particularly for patients who do not respond to conventional therapies.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"16 1","pages":"101481"},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the current provision of pancreatic transplantations in low- and middle-income countries: Current landscape, challenges, future prospects.","authors":"Hareesha Rishab Bharadwaj, Joecelyn Kirani Tan, Syed Hasham Ali, Muhammad Hamza Shah, Aderinto Nicholas, Khabab Abbasher Hussien Mohamed Ahmed, Khansa Irfan, Priyal Dalal, Aashna Mehta, Wireko Andrew Awuah, Arkadeep Dhali","doi":"10.4291/wjgp.v15.i6.94590","DOIUrl":"https://doi.org/10.4291/wjgp.v15.i6.94590","url":null,"abstract":"<p><p>This comprehensive review addresses the global health challenge of disparities in pancreas transplant access, particularly in low- and middle-income countries (LMICs) compared to high-income countries. Despite advancements in surgical techniques and immunosuppression for procedures like simultaneous pancreas-kidney, pancreas-after-kidney, and pancreas-transplant alone, LMICs face significant challenges, including limited infrastructure, financial constraints, and a shortage of skilled medical professionals. Donation after brain death remains constrained by sociocultural barriers. Region-specific analyses highlight progress in Latin America, Asia, Russia, and South Africa, showcasing the regional disparities in access and outcomes. Future prospects involve minimally invasive surgeries, telemedicine for enhanced post-operative care, international collaborations with organizations like the European Union of Medical Specialists, and robust funding networks to improve organ availability. In conclusion, the review underscores the importance of multifaceted strategies to address economic, sociocultural, and infrastructural barriers, aiming to improve accessibility, quality, and effectiveness of pancreas transplantation services in LMICs.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"15 6","pages":"94590"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}