Annals of Gastroenterology最新文献

{"title":"Granulocyte and monocyte adsorptive apheresis for ulcerative colitis: mechanisms, clinical evidence, and future perspectives.","authors":"Tomotaka Tanaka, Yoshikazu Yoshifuku, Hajime Teshima, Hirona Konishi, Kazuyoshi Nakata, Kosei Kitamura, Nodoka Otabe, Takeshi Mori, Songde Cho, Michihiro Nonaka, Yoshifumi Fujimoto","doi":"10.20524/aog.2026.1076","DOIUrl":"10.20524/aog.2026.1076","url":null,"abstract":"<p><p>Ulcerative colitis (UC) is a chronic, idiopathic inflammatory bowel disease characterized by continuous mucosal erosions and ulcers in the colon. In recent years, biologics and small-molecule agents have revolutionized UC management; however, these therapies may be limited by risks such as infections, secondary loss of response, or intolerance. Granulocyte and monocyte adsorptive apheresis (GMA), developed in Japan, offers a non-pharmacologic and selective immunomodulatory approach by removing activated myeloid cells and modulating the inflammatory milieu. In this review, we summarize the mechanisms of action of GMA, including its effects on proinflammatory cytokines and regulatory T-cell responses. We also examine the clinical evidence, from randomized controlled trials and observational studies, that supports its efficacy, particularly in steroid-dependent and elderly patients. While mucosal healing rates with GMA may be lower than those achieved with biologics, its favorable safety profile may support its use as an adjunctive or bridging strategy in selected patients. However, evidence supporting these roles remains limited and is derived mainly from observational studies. Future directions include integration with personalized medicine, biomarker development and global expansion. GMA remains a viable option in the therapeutic landscape of UC.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"405-408"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417817","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":"Solid pseudopapillary epithelial neoplasm of the pancreas: an audit of 29 cases operated in a tertiary Indian centre.","authors":"Pritesh Kumar N, Vageesh Bg, Anil Agarwal","doi":"10.20524/aog.2026.1068","DOIUrl":"10.20524/aog.2026.1068","url":null,"abstract":"<p><strong>Background: </strong>Solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is an indolent tumor of rare occurrence seen predominantly in young females in the 2^nd to 4^th decade. These tumors tend to grow large, producing a mass effect, or may show local invasiveness.</p><p><strong>Method: </strong>This is a retrospective analysis of a prospectively maintained database of SPEN cases operated at a tertiary care hospital in India from 2011-2023.</p><p><strong>Results: </strong>The cohort consisted of 29 patients with a male: female ratio of 1:8.6, and a median age of 24 years. The majority of the lesions were in the body and tail of the pancreas (65.5%). Mean tumor diameter was 6.1±1.9 cm. Pancreatic resection (9 distal pancreatectomies, 7 Whipple'spancreaticoduodenectomies, 2 central pancreatectomies) was undertaken in the majority of cases (62.1%), while 11 patients (37.9%) underwent enucleation. Additional resections included splenectomy (n=4), segmental colonic resection (n=2), and 1 non-anatomical liver wedge resection for solitary liver metastasis. Mean operative time and blood loss were 222.1±106.1 min and 115.5±85.9 mL, respectively. Minor complications were seen in 7 (24.1%) patients, while 1 patient had a major complication. At a median follow up of 37 months, 28 (96.6%) patients were alive, 1 of whom had local recurrence.</p><p><strong>Conclusions: </strong>SPEN represents an indolent, low-grade malignant tumor that is reasonably diagnosed preoperatively by cross-sectional imaging. The majority of cases are cured by surgical resection, the extent of which is dictated by the location of the tumor and its relation to surrounding structures. Excellent outcomes, both short- and long-term, can be achieved.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"464-470"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417886","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":"Comparative outcomes and characteristics of biliary, alcoholic and drug-induced pancreatitis based on the National Inpatient Sample (2016-2021).","authors":"Omar Alkasabrah, Sameeha Ibrahim, Abdullah Hafeez, Tungki Pratama Umar, Marina Takawy, Tanuj Sharma","doi":"10.20524/aog.2026.1072","DOIUrl":"10.20524/aog.2026.1072","url":null,"abstract":"<p><strong>Background: </strong>Pancreatitis outcomes vary significantly depending on etiology. We compared biliary, alcoholic and drug-induced pancreatitis, focusing on mortality, complications and healthcare resource utilization to inform etiology-specific management strategies.</p><p><strong>Methods: </strong>A nationwide retrospective analysis was conducted using the National Inpatient Sample (NIS) database from 2016-2021. Patients with biliary, alcoholic and drug-induced pancreatitis were identified using International Classification of Diseases, 10^th Revision (ICD-10) codes. Logistic regression models were used to compare mortality, complications and healthcare utilization, with biliary pancreatitis as the reference. Adjusted odds ratios (aORs) and regression coefficients were calculated.</p><p><strong>Results: </strong>A total of 287,050 biliary, 451,730 alcoholic, and 27,465 drug-induced pancreatitis hospitalizations were identified. Patients with alcoholic pancreatitis were younger and predominantly male, while those with drug-induced pancreatitis had higher comorbidity burdens, including diabetes, dyslipidemia and hypertension. Mortality was higher in alcoholic pancreatitis (aOR 1.19, 95% confidence interval [CI] 1.06-1.41; P=0.05), whereas drug-induced pancreatitis showed no significant difference. Alcoholic pancreatitis was associated with greater odds of pseudocyst formation (aOR 3.54, 95%CI 3.32-3.79), bleeding (aOR 1.52, 95%CI 1.41-1.63), and mechanical ventilation (aOR 2.06, 95%CI 1.84-2.31), all with P<0.001. In contrast, drug-induced pancreatitis was linked to lower odds of bleeding (aOR 0.69, 95%CI 0.57-0.84; P<0.001) and percutaneous drainage (aOR 0.23, 95%CI 0.09-0.63; P=0.004). Both alcoholic and drug-induced pancreatitis had shorter hospital stays and lower total charges compared with biliary pancreatitis.</p><p><strong>Conclusions: </strong>Alcoholic pancreatitis is associated with higher mortality and complication rates, while drug-induced pancreatitis demonstrates fewer complications but greater comorbidity. These findings highlight the importance of etiology-based management in optimizing pancreatitis outcomes.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"438-445"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417713","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":"Emerging endoscopic resection strategies for organ preservation in early colorectal cancer.","authors":"Marianna Spinou, Antonis Pikoulas, Petros Zormpas, Dimitrios Dimitriadis, Eleni Nakou, Margarita Eleni Manola, Evangelos Voudoukis, Gregorios Paspatis, George Tribonias","doi":"10.20524/aog.2026.1080","DOIUrl":"10.20524/aog.2026.1080","url":null,"abstract":"<p><p>The management of early colorectal cancer (CRC) is increasingly debated among gastroenterologists and colorectal surgeons, driven by advances in endoscopic resection that enable curative organ-preserving treatment. Conventional endoscopic mucosal resection (EMR) remains the first-line small-to-moderate sized superficial lesions, although its application is limited for larger or fibrotic polyps, because of piecemeal resection and higher recurrence rates. Modified EMR techniques, including anchoring, precutting, and underwater EMR, are widely available and achieve superior technical outcomes without compromising safety, thus broadening the indications for endoscopic resection of low-risk neoplastic lesions. Endoscopic submucosal dissection (ESD) allows <i>en bloc</i> resection regardless of lesion size, and provides accurate histopathological evaluation even when curative criteria are not met, though its use is constrained by its technical complexity and limited availability. For rectal lesions exhibiting features suggestive of deep submucosal invasion, endoscopic intermuscular dissection may serve as an effective endoscopic therapeutic option, as it extends the resection plane into the intermuscular space, achieving clear vertical margins while facilitating organ preservation. Endoscopic full-thickness resection, alone or combined with EMR/ESD, addresses non-lifting, fibrotic or anatomically challenging lesions throughout the colon. Together, these modalities have reshaped the therapeutic landscape of endoscopy, allowing curative and organ-sparing management of early CRCs. This review summarizes organ-preserving endoscopic approaches for early CRC, and proposes a practical algorithm for technique selection while identifying key evidence gaps and future directions.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"409-423"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417825","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":"Effect of GLP-1 receptor agonists on upper gastrointestinal endoscopy outcomes: a systematic review and meta-analysis.","authors":"Konstantinos Malandris, Savvas Papachristou, Lito Psychou Derka, Georgios Kalopitas, Eleni Gkoura, Aris Liakos, Thomas Karagiannis, Eleni Theocharidou, Anastasios Manolakis, Eleni Bekiari, Apostolos Tsapas","doi":"10.20524/aog.2026.1067","DOIUrl":"10.20524/aog.2026.1067","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) delay gastric emptying, raising concerns about potential aspiration risk during upper gastrointestinal (GI) endoscopy. We conducted a systematic review and meta-analysis to evaluate the effect of GLP-1 RA therapy on procedural outcomes in patients undergoing upper GI endoscopy.</p><p><strong>Methods: </strong>We searched Medline and Cochrane library up to July 2025 without restrictions. Eligible studies evaluated patients undergoing upper GI endoscopy, comparing those taking GLP-1 RAs with those who were not. Outcomes of interest were the incidence of retained gastric contents (RGC), bronchopulmonary aspiration, and procedure discontinuation. Pooled estimates are expressed as odds ratios (ORs) with 95% confidence intervals (CIs), using a random-effects meta-analysis with inverse variance weighting.</p><p><strong>Results: </strong>Twenty-four observational studies, predominantly retrospective, met the inclusion criteria: these comprised 184,707 participants, of whom 59,095 were taking GLP-1 RAs. Mean age was 58.7 years, 48.8% were women, and 51.2% had type 2 diabetes. Use of GLP-1 RAs was associated with higher rates of RGC (OR 4.82, 95%CI 3.66-6.35) and procedure discontinuation (OR 3.93, 95%CI 2.42-6.39) compared with control treatment. In contrast, the incidence of aspiration events was similar between groups (OR 1.1, 95%CI 0.84-1.48). Results remained consistent in a sensitivity analysis based on propensity score matching to control for confounders.</p><p><strong>Conclusions: </strong>GLP-1 RA therapy is associated with a greater incidence of RGC and higher rates of endoscopy termination, but not with a higher risk of aspiration. Adjusting the fasting duration, rather than routinely discontinuing GLP-1 RAs, may represent a reasonable management approach.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"452-463"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417876","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":"Immune-mediated diarrhea with normal investigations: the importance of diagnostic stratification and small-bowel assessment.","authors":"Steven Nicolaides, Zaid Ardalan, Alex Boussioutas","doi":"10.20524/aog.2026.1071","DOIUrl":"10.20524/aog.2026.1071","url":null,"abstract":"","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"495"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417833","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":"Blood eosinophilia in patients with inflammatory bowel disease losing response to biologics.","authors":"Amine Souhayl, Anneline Cremer, Leila Amininejad, Charlotte Minsart, Denis Franchimont, Claire Liefferinckx","doi":"10.20524/aog.2026.1081","DOIUrl":"10.20524/aog.2026.1081","url":null,"abstract":"<p><strong>Background: </strong>Emerging data suggest that blood eosinophilia may be linked to inflammatory bowel disease (IBD) activity and biologic treatment failure. This study assessed the occurrence of eosinophilia in IBD patients experiencing biologic failure.</p><p><strong>Methods: </strong>This was a single-center retrospective study of IBD patients treated with infliximab (IFX) or vedolizumab (VDZ) between 2017 and 2023. Demographics, disease characteristics, disease activity, treatment modifications, together with data on blood eosinophilia and persistent blood eosinophilia, were recorded at 1-year follow up following treatment initiation with biologics. The outcomes were rate of biologic failure, hospitalizations, and surgery at 1 year. Uni- and multivariate analyses were performed to identify factors associated with these outcomes.</p><p><strong>Results: </strong>The study included 154 patients, 96 with Crohn's disease (CD) (62.3%) and 58 with ulcerative colitis (UC) (37.7%). The occurrence of blood eosinophilia was observed in 22% of patients over 1 year of followup. In univariate analysis, factors associated with biologic failure included previous biologic exposure (P<0.001), baseline immunosuppressants (P=0.009), baseline perinuclear antineutrophil cytoplasmic antibody (P=0.041), and blood eosinophilia (P=0.037). Blood eosinophilia was associated with a higher risk of VDZ failure (odds ratio [OR] 2.81, 95% confidence interval [CI] 1.01-8.10; P=0.047) and was more frequently observed in patients with CD than in UC (OR 2.97, 95%CI 1.05-8.91; P=0.040). Multivariate analysis confirmed the association of blood eosinophilia and biologic failure (OR 2.65, 95%CI 1.08-6.65; P=0.034).</p><p><strong>Conclusion: </strong>Blood eosinophilia was independently associated with biologic failure at 1 year in IBD patients and may represent a risk-stratifying biomarker.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"471-479"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417623","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":"Increased risk of <i>de novo</i> inflammatory bowel disease following cholecystectomy: a population-based analysis.","authors":"Saqr Alsakarneh, Razan Aburumman, June Tome, Abdulla Massad, Michael Camilleri, Francis A Farraye, Jana G Hashash","doi":"10.20524/aog.2026.1074","DOIUrl":"10.20524/aog.2026.1074","url":null,"abstract":"<p><strong>Background: </strong>Cholecystectomy (CCY) may alter bile acid flow and gut microbiota, increasing the risk of gastrointestinal disease. Prior studies have suggested that CCY may be associated with bile acid diarrhea and microscopic colitis; however, the association with the new diagnosis of inflammatory bowel disease (IBD) remains unstudied. In this study, we evaluated whether CCY was associated with a greater risk of <i>de novo</i> IBD.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study, analyzing data from the TriNetX network (2010-2024), using 1:1 propensity score matching between adult patients undergoing CCY and controls, based on variables that included demographics, comorbidities and medication use. The primary outcome was risk of <i>de novo</i> IBD. Secondary outcomes included the risk of developing ulcerative colitis (UC) or Crohn's disease (CD). Kaplan-Meier analysis with hazard ratios (HRs) and 95% confidence intervals (CIs) was used to compare time-to-event rates.</p><p><strong>Results: </strong>Among 570,317 matched pairs, CCY was associated with a greater risk of IBD (adjusted HR [aHR] 1.29, 95%CI 1.22-1.35; P<0.001), and specifically CD (aHR 1.83, 95%CI 1.69-1.99; P<0.001), but not the risk of UC. This elevated risk persisted across both sexes and all age groups. Among patient characteristics, tobacco use was associated with the greatest additional risk of IBD post-CCY (aHR 1.43, 95%CI 1.19-1.76; P<0.001).</p><p><strong>Conclusions: </strong>Prior CCY is associated with a greater risk of CD but not UC. These findings support the need for a low threshold to think about CD in patients with gastrointestinal symptoms after CCY.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"424-429"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417874","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":"Incidentally discovered, intentionally managed: a narrative review of the last decade's updates on the management of neuroendocrine tumor of the appendix.","authors":"Salvatore Raia, Maria Rita Gaia Livatino, Giorgio Maria Orazi, Maria Grazia Maratta, Enza Genco, Romina Grazia Giancipoli, Vittoria Rufini, Ernesto Rossi, Sabrina Chiloro, Claudio Fiorillo, Sergio Alfieri, Giampaolo Tortora, Alfredo Pontecorvi, Guido Rindi, Antonio Bianchi, Giovanni Schinzari","doi":"10.20524/aog.2026.1070","DOIUrl":"10.20524/aog.2026.1070","url":null,"abstract":"<p><p>Appendiceal neuroendocrine neoplasms (aNENs) represent an increasingly recognized and heterogeneous subset of gastroenteropancreatic neuroendocrine tumors (NETs), most often identified incidentally on appendectomy specimens. Postoperative management relies on accurate risk stratification grounded in histopathological assessment and aligned with major international guidelines (WHO, ENETS), which distinguish between well-differentiated NETs (NET grades 1 to 3) and poorly differentiated neuroendocrine carcinomas. Critical prognostic determinants shaping therapeutic decision-making include tumor size, proliferative index (Ki-67), depth of invasion-particularly mesoappendiceal involvement-and lymphovascular invasion (LVI). Consensus recommendations suggest simple appendectomy as definitive treatment for low-risk tumors (<1 cm) and right hemicolectomy for high-risk lesions (>2 cm) or those exhibiting LVI. However, the management of intermediate-sized aNENs (1.0-2.0 cm) remains the principal area of clinical uncertainty, with emerging data suggesting that appendectomy alone may be sufficient for carefully selected patients without adverse pathological factors. This review synthesizes and critically appraises the most recent evidence and international guidelines with the goal of refining current clinical practice. In particular, it provides an updated framework for individualized risk stratification, evaluates the balance between oncological benefit and procedural morbidity in determining the optimal surgical approach, and outlines evidence-based surveillance strategies to support a more consistent, risk-adapted multidisciplinary management of aNENs.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"390-404"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417895","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":"Prior bariatric surgery and better short-term outcomes in acute pancreatitis: a multicenter propensity-matched analysis.","authors":"Khalid Ahmed, Abdellatif Ismail, Ayman Elawad, Mohammed Al-Aquily, Tarig Elhakim, Mohamed Abdallah, Ahmed Dirweesh","doi":"10.20524/aog.2026.1062","DOIUrl":"10.20524/aog.2026.1062","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with an increased risk of severe acute pancreatitis (AP). Bariatric surgery is known to improve comorbidities and reduce systemic inflammatory burden. We aimed to evaluate whether a history of bariatric surgery is associated with differences in short-term clinical outcomes among patients hospitalized with AP.</p><p><strong>Methods: </strong>Retrospective study using the TriNetX research network, including adults aged 18 years or older who were hospitalized with AP. Patients with chronic pancreatitis, pancreatic malignancy or cystic pancreatic disease were excluded. Study cohorts were defined based on the presence or absence of prior bariatric surgery performed at least 1 year before the AP admission. Cohorts were matched 1:1 using propensity scores. The primary outcome was 30-day all-cause mortality. Secondary outcomes were acute kidney injury (AKI), need for hemodialysis, endotracheal intubation, vasopressor use, elevations in inflammatory markers, and pancreatitis-related procedures, such as endoscopic retrograde cholangiopancreatography (ERCP) with stent placement, cholecystectomy, and pancreatic debridement.</p><p><strong>Results: </strong>After matching, both cohorts included 4024 patients. Bariatric patients had significantly lower 30-day mortality (1.9% vs. 2.6%; relative risk [RR] 0.71, 95% confidence interval [CI] 0.53-0.95; P=0.021), less AKI (0.8% vs. 1.5%; RR 0.54, 95%CI 0.35-0.82; P=0.003), and less hemodialysis (0.5% vs. 0.9%; RR 0.54, 95%CI 0.31-0.93; P=0.025). ERCP with stent placement was less frequent in the bariatric group (1.0% vs. 1.6%; RR 0.60, 95%CI 0.40-0.89; P=0.011). Other secondary outcomes did not differ significantly between groups.</p><p><strong>Conclusions: </strong>Bariatric surgery was associated with better short-term outcomes in AP. This included lower mortality and renal complications, possibly via metabolic and inflammatory effects.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"446-451"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417812","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}