Annals of Gastroenterology最新文献

{"title":"Lipoprotein (a) and inflammatory bowel disease: a systematic review and meta-analysis.","authors":"Christina Mastori-Kourmpani, Anastasios Makris, Magdalini Rigina Fragkouli, Constantinos Philippou, Georgios Hadjigeorgiou, Dimitrios Giannakakis, Constantinos Tsioutis, Aris P Agouridis","doi":"10.20524/aog.2026.1079","DOIUrl":"10.20524/aog.2026.1079","url":null,"abstract":"<p><strong>Background: </strong>Lipid profile alterations have been reported in patients with inflammatory bowel disease (IBD). Our aim was to systematically investigate all relevant evidence on the association between lipoprotein (a) [Lp(a)] and IBD.</p><p><strong>Methods: </strong>We searched PubMed and Cochrane Library databases (up to 30 December 2024) for studies with evidence on Lp(a) in patients with IBD. A meta-analysis was performed to evaluate the mean differences (MD) in Lp(a) between patients with Crohn's disease (CD) or ulcerative colitis (UC), and healthy controls (HC).</p><p><strong>Results: </strong>The literature search identified 11 studies (2687 participants) investigating the lipid profile of patients with IBD; however, only 6 studies were used for the meta-analysis. Overall, 1978 participants were included in the meta-analysis, of whom 1196 were IBD patients and 782 were HC. The pooled analysis from 4 studies showed that CD patients had significantly higher Lp(a) levels compared to HC (MD 18.36 mg/dL, 95% confidence interval [CI] 14.53-22.20; P<0.001). Similarly, a pooled analysis from 4 studies showed that UC patients had higher Lp(a) levels compared to HC (MD 7.32 mg/dL, 95% CI 2.85-11.79; P=0.001). A pooled analysis of 3 studies revealed a non-significant difference in Lp(a) levels between CD and UC patients. In subgroup analyses based on disease activity, CD patients with active disease exhibited significantly higher Lp(a) levels compared to those with inactive disease. No significant difference was observed in UC patients stratified by disease activity.</p><p><strong>Conclusions: </strong>Lp(a) levels are significantly higher in both CD and UC patients compared to HC. Therefore, Lp(a) evaluation is advisable when assessing IBD patients.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 5","pages":"563-570"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148672918","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":"Functional and long-term outcomes of ileorectal versus ileal pouch-anal anastomosis for familial adenomatous polyposis: a systematic review and meta-analysis.","authors":"Umar Hayat, Amna Iqbal, Daniyal Raza, Iqra Arshad, Naeem Ijaz, Aamir Saeed, Aman Ali, Ali A Siddiqui, Douglas G Adler","doi":"10.20524/aog.2026.1087","DOIUrl":"10.20524/aog.2026.1087","url":null,"abstract":"<p><strong>Background: </strong>Colectomy with ileorectal anastomosis (IRA) or proctocolectomy with ileal pouch-anal anastomosis (IPAA) are the 2 standard prophylactic surgical options for patients with familial adenomatous polyposis (FAP). We aimed to compare the functional and long-term outcomes of IRA and IPAA among FAP patients.</p><p><strong>Methods: </strong>We searched large databases to identify studies evaluating the functional outcomes of prophylactic surgical modalities for FAP. The primary outcomes of interest were the functional outcomes of IRA with IPAA, including fecal incontinence, fecal urgency, use of pads for defecation, and use of antidiarrheal drugs. Secondary outcomes included the social outcomes of the 2 procedural modalities, early postoperative adverse events, and long-term adverse events.</p><p><strong>Results: </strong>Compared with IPAA, FAP patients who underwent IRA had a lower frequency of fecal incontinence (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.41-0.76; P<0.001), but were more likely to have fecal urgency (OR 1.53, 95%CI 1.08-2.15; P=0.02). There was no difference in the use of pads and antidiarrheals between the 2 groups (OR 0.55, 95%CI 0.27-1.11; P=0.09; and OR 0.83, 95%CI 0.57-1.22; P=0.35, respectively). Moreover, there was no difference in social outcomes or perioperative adverse events (OR 1.19, 95%CI 0.53-2.68; P=0.68; and OR 0.73, 95%CI 0.50-1.06; P=0.10, respectively). Lastly, IRA had lower long-term complications than IPAA (OR 0.78, 95%CI 0.63-0.97; P=0.03).</p><p><strong>Conclusion: </strong>IRA has better functional outcomes regarding fecal incontinence, a better prophylactic intervention profile, and fewer long-term complications.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 5","pages":"588-596"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148672909","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":"Single incision laparoscopic surgery for ileal J-pouch-anal anastomosis: a 15-year review of the literature.","authors":"Evangelia Balla, Dimitrios Dimitroulis, Nikolaos Garmpis, Ilektra Kyrochristou, Nikolaos Nikiteas, Dimitrios Patsouras","doi":"10.20524/aog.2026.1027","DOIUrl":"10.20524/aog.2026.1027","url":null,"abstract":"<p><p>Single-incision laparoscopic surgery (SILS) has emerged as a refinement of minimally invasive techniques, offering potential cosmetic and postoperative recovery benefits. This review aimed to evaluate the current evidence regarding the safety, feasibility, and outcomes of SILS for ileal J-pouch-anal anastomosis (IPAA). A structured literature search was performed in PubMed for studies published between January 2010 and January 2025, focusing on adult and pediatric patients undergoing restorative proctocolectomy with IPAA performed through a single incision. Twenty-two studies were identified, encompassing 182 procedures. The mean operative time ranged from 144-284 min. Reported conversion to multiport laparoscopy or open surgery occurred in 3.9% of cases, while the mean estimated blood loss varied from 27-136 mL. The median length of hospital stay was 4 days in most studies. Major postoperative complications (Clavien-Dindo grade ≥III) occurred in approximately 9% of patients, most commonly small-bowel obstruction or anastomotic leak. Cosmetic satisfaction and postoperative pain scores were generally favorable, although long-term functional outcomes were rarely reported. SILS-IPAA appears feasible and safe in selected patients, particularly when performed by experienced surgeons familiar with conventional laparoscopic restorative proctocolectomy. The current literature is heterogeneous and limited by small sample sizes and overlapping institutional data. Further comparative studies, especially in the context of robotic platforms, are needed to define the role of SILS in modern pouch surgery.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 1","pages":"1-10"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12850686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146083964","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":"A prospective international multisite randomized controlled trial of water exchange with and without distal cap(s) in adenoma detection.","authors":"Felix W Leung, Sergio Cadoni, Long Chen, Yu Chen, Chi-Liang Cheng, Ramsey Cheung, Vivek Dixit, David Elashoff, Shai Friedland, Paolo Gallittu, Yu-Hsi Hsieh, Chia Hsin Cheng, Noam Jacob, Nora Jamgotchian, Hui Jia, Yen-Lin Kuo, Bai-Ping Lee, Joseph W Leung, Donatella Mura, Jennifer Yi-Jiun Pan, Yanglin Pan, Susan Y Quan, Angshuman Saha, Aliya Shaikh, James Sul, Chih-Wei Tseng, Yi-Ning Tsui, Holly Wilhalme, Robert J Wong, Andrew W Yen, Linhui Zhang","doi":"10.20524/aog.2026.1020","DOIUrl":"10.20524/aog.2026.1020","url":null,"abstract":"<p><strong>Background: </strong>Interval cancers are linked to a low adenoma detection rate (ADR), prompting calls for benchmark-guided ADR performance improvement. Although water exchange and a straight cap (CAP) have been reported to independently improve ADR, the effects of Daisycuff^™ and Endocuff Vision^® remained unknown. We hypothesized that selected cap(s) could increase ADR and related water exchange outcomes.</p><p><strong>Methods: </strong>Subjects were randomized to No cap, or CAP, Daisycuff^™ and Endocuff Vision^® at 7, 5 and 2 sites. The primary outcome was ADR. Outcomes were compared for No cap vs. the above randomized caps.</p><p><strong>Results: </strong>Demographic and historic data revealed adequate randomization. Despite variations in site-specific pretrial ADR, the aggregated data showed that the ADR of No cap (45.6%) exceeded the latest benchmark (35%). Each added cap increased the ADR, and the difference using Daisycuff^™(52.8%) approached statistical significance (P=0.05). In the right colon, CAP and Daisycuff^™ significantly increased ADR. In the left colon, Daisycuff^™ significantly increased adenoma per colonoscopy. Factors that improved adenoma detection were consistent with published reports. Detection rates based on site, indication, sedation type, polyp size, shape and pathology in the No cap group were consistent with conventional data and were not influenced by the caps.</p><p><strong>Conclusions: </strong>The significantly higher right-colon ADRs with CAP and Daisycuff^™ suggest potential clinical relevance for reducing interval cancers. Although water exchange with or without caps yields ADRs that surpass the benchmark, the positive findings for selected cap(s) need to be confirmed in order to enhance the options for further improvement of water exchange.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 1","pages":"104-113"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12850690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146083975","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 and colitis with normal biochemical, endoscopic and histologic findings: a retrospective study.","authors":"Malek Shatila, Sharada Wali, Carolina Colli Cruz, Kei Takigawa, Andres Caleb Urias Rivera, Kian Abdul-Baki, Tanvi Gupta, Elliot Baerman, Linfeng Lu, Irene Jeong-Ah Lee, Raakhi Menon, Hamza Salim, Andrew Sullivan, Varun Vemulapalli, Cristina Natha, Ayesha Khan, Krishnavathana Varatharajalu, Stephane Champiat, Kerry L Reynolds, Lucy B Kennedy, Katy Tsai, Anusha Shirwaiker Thomas, Yinghong Wang","doi":"10.20524/aog.2026.1028","DOIUrl":"10.20524/aog.2026.1028","url":null,"abstract":"<p><strong>Background: </strong>Immune-mediated diarrhea and colitis (IMDC) due to checkpoint inhibition infrequently presents with normal stool biomarkers and no endoscopic or histologic evidence of inflammation. Little is known about the treatment needs and outcomes of this subset of patients. We aimed to describe this entity and clarify the role of immunosuppressive treatments in its management.</p><p><strong>Method: </strong>This was a single-center, retrospective study of patients treated with immune checkpoint inhibitors who developed clinical symptoms of IMDC, with no evidence of inflammation based on fecal calprotectin or endoscopic/histologic evaluation, between January 2010 and February 2024.</p><p><strong>Results: </strong>Of 1151 patients with IMDC, 131 (11.4%) had no evidence of inflammation. These patients more frequently had PD-1/L1 agent exposure (P=0.019) and presented with less severe diarrhea than patients with evidence of inflammation (P<0.001). This group had a lower rate of hospitalization (P=0.003). Around 40% of patients with no evidence of inflammation required immunosuppressive treatment. There was no difference in clinical symptoms or severity between patients requiring immunosuppression and those who did not.</p><p><strong>Conclusions: </strong>Our study is the first to explore IMDC with no elevations in calprotectin and normal endoscopic/histologic findings. We found that PD-1/PD-L1 inhibition may predispose patients to developing this form of IMDC, which is associated with a lower severity of diarrhea, fewer hospitalizations and lower recurrence rates. Many patients still require immunosuppressive treatment, and a small subset later develop colonic inflammation. Future studies are needed to further elucidate the treatment needs and outcomes of this patient population.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 1","pages":"79-87"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12850695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146083889","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":"MUC1 as a biomarker in primary sclerosing cholangitis and cholangiocarcinoma.","authors":"Jana G Hashash, Pamela Beatty, Irene K Yan, Raouf Nakhleh, Micheal Camilleri, Denise Harnois, Francis A Farraye, Fadi F Francis","doi":"10.20524/aog.2026.1021","DOIUrl":"10.20524/aog.2026.1021","url":null,"abstract":"<p><strong>Background: </strong>MUC1 is a glycoprotein expressed at low levels in fully glycosylated form on healthy epithelial cells. In inflammation and malignancy, MUC1 becomes overexpressed and hypoglycosylated. We aimed to describe patterns of MUC1 expression in bile-duct tissue of patients with primary sclerosing cholangitis (PSC), PSC/cholangiocarcinoma, cholangiocarcinoma, and healthy controls.</p><p><strong>Methods: </strong>In this proof-of-concept pilot study, archived human liver tissue samples were identified and stained using anti-MUC1 antibodies. Staining for all MUC1, and specifically hypoglycosylated MUC1, was performed.</p><p><strong>Results: </strong>Tissue from controls minimally expressed the hypoglycosylated/abnormal MUC1. Tissue from patients with PSC demonstrated moderate expression. Very high levels were expressed in sporadic cholangiocarcinoma.</p><p><strong>Conclusion: </strong>MUC1 may serve as a biomarker in the identification of bile-duct disease and cancer.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 1","pages":"48-53"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12850687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146083930","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":"Clinical outcomes following endoscopic retrograde cholangiopancreatography-based therapy compared with surgery in chronic pancreatitis: evidence from a multicentric cohort.","authors":"Arkadeep Dhali, Rick Maity, Fayaz Khan, Jyotirmoy Biswas, Sukanta Ray","doi":"10.20524/aog.2026.1097","DOIUrl":"10.20524/aog.2026.1097","url":null,"abstract":"<p><strong>Background: </strong>Real-world comparative outcomes of endoscopic retrograde cholangiopancreatography-based endoscopic therapy vs. pancreatic surgery in chronic pancreatitis (CP) remain incompletely defined.</p><p><strong>Methods: </strong>We performed a retrospective comparative effectiveness study using the TriNetX US Collaborative Network. Adults with CP undergoing endoscopic therapy or pancreatic surgery were identified, and propensity score matching generated 1451 patients in each cohort. Outcomes were assessed from 1-1095 days after the index event, using risk-based analyses as the primary comparative summaries and Kaplan-Meier analyses as secondary time-to-event summaries. Outcomes included chronic opioid prescriptions, opioid use disorder (OUD), celiac plexus block/neurolysis, pain codes, acute pancreatitis, exocrine and endocrine pancreatic insufficiency, emergency visits, and all-cause mortality.</p><p><strong>Results: </strong>Mean follow up was 771.494 days for endoscopy and 827.285 days for surgery. New chronic opioid prescriptions occurred in 146/1092 (13.4%) endoscopic vs. 79/1032 (7.7%) surgical patients (odds ratio [OR] 1.862, 95% confidence interval [CI] 1.396-2.484; P<0.001; hazard ratio [HR] 1.861, 95%CI 1.415-2.448). Acute pancreatitis occurred in 167/530 (31.5%) vs. 65/565 (11.5%) patients (OR 3.539, 95%CI 2.578-4.858; P<0.001; HR 3.341, 95%CI 2.506-4.453). Exocrine pancreatic insufficiency occurred in 200/1213 (16.5%) vs. 132/1206 (10.9%) patients (OR 1.606, 95%CI 1.269-2.034; P<0.001; HR 1.585, 95%CI 1.272-1.975). Endocrine pancreatic insufficiency, mortality, emergency visits, and OUD did not differ significantly between cohorts.</p><p><strong>Conclusions: </strong>Endoscopic therapy was associated with higher chronic opioid prescribing, acute pancreatitis, celiac plexus block/neurolysis, and exocrine pancreatic insufficiency. These findings are associative and should be interpreted in the context of residual confounding and coding-based outcome ascertainment.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 5","pages":"534-542"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148672867","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":"Cystic duct anatomical variations and the risk of choledocholithiasis: a systematic review and meta-analysis.","authors":"Dimosthenis Chrysikos, Nikolaos Taprantzis, Amir Shihada, Theodore Troupis","doi":"10.20524/aog.2026.1095","DOIUrl":"10.20524/aog.2026.1095","url":null,"abstract":"<p><strong>Background: </strong>Cystic duct anatomy is clinically significant for surgery and stone formation, yet the literature lacks a systematic analysis linking variations to common bile duct stones. This study investigated their prevalence and risk for choledocholithiasis.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Web of Science and Scopus for studies on cystic duct morphology and choledocholithiasis. Pooled prevalence, risk ratios (RRs), and odds ratios were calculated using R; heterogeneity and bias were assessed via AQUA and Peter's tests.</p><p><strong>Results: </strong>High (17.2%) and posterior (13.8%) insertions were most prevalent. Factors significantly associated with choledocholithiasis included a long cystic duct (RR 1.50, 95% confidence interval [CI] 1.18-1.90), low insertion (RR 1.46, 95%CI 1.06-1.76), spiral course (RR 1.41, 95%CI 1.06-1.86), and posterior insertion (RR 1.32, 95%CI 1.07-1.60). Lithiasis patients exhibited wider cysto-choledochal angles (47.1° vs. 40.8°). Geographic analysis revealed a high prevalence of low insertion in African populations (21.8%) and spiral ducts in East Asians.</p><p><strong>Conclusions: </strong>Cystic duct variations significantly increase susceptibility to choledocholithiasis and pose surgical challenges. As these complex anatomical courses and configurations are often missed, preoperative imaging is essential. Early identification enables safer surgical planning, reduces biliary injury risk, and can guide tailored strategies to prevent lithiasis in high-risk groups.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 5","pages":"543-551"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148672847","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 efficacy and safety of endoscopic ultrasound-guided gastrojejunostomy versus surgical gastrojejunostomy for the management of gastric outlet obstruction: a systematic review and meta-analysis.","authors":"Ioannis Karniadakis, Stavros P Papadakos, Vasiliki Vrachni, Maria Sotiropoulou, Dimitrios Tsironis, Andrew Wan, Dimitrios Schizas","doi":"10.20524/aog.2026.1085","DOIUrl":"10.20524/aog.2026.1085","url":null,"abstract":"<p><strong>Background: </strong>Gastric outlet obstruction (GOO) is a common condition leading to impaired gastric emptying and nutritional decline. Surgical gastrojejunostomy (SGJ) has been the traditionally used bypass approach. Endoscopic ultrasound-guided gastrojejunostomy (EUSGJ) has recently emerged as a promising alternative. This systematic review and meta-analysis aimed to compare the efficacy and safety of EUSGJ vs. SGJ for the management of GOO.</p><p><strong>Methods: </strong>PubMed, Embase, MEDLINE and Cochrane were searched to identify studies that specifically compared outcomes of EUSGJ vs. SGJ in GOO patients. Outcomes assessment focused on procedural metrics and immediate postoperative recovery.</p><p><strong>Results: </strong>Nine retrospective studies incorporating 1086 patients were included. SGJ was superior in terms of technical success (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.05-0.45; P<0.001). EUSGJ was superior in terms of length of hospital stay (mean difference [MD] -4.79, 95%CI -6.52 to -3.06; P<0.001), overall complications (OR 0.24, 95%CI 0.17-0.33, P<0.001), ileus (OR 0.07, 95%CI 0.02-0.17; P<0.001), operative time (MD -96.89, 95%CI -146.16 to -47.61; P<0.001) and infection (OR 0.17, 95%CI 0.08-0.37; P<0.001). No significant differences were demonstrated in terms of clinical success, reintervention, hemorrhage, and perforation.</p><p><strong>Conclusions: </strong>EUSGJ is a safe alternative to SGJ for the palliation of GOO in the arsenal of expert endoscopists. Further research is warranted to establish its place in the complex decision-making process around GOO management in the context of individualized patient care.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 5","pages":"605-613"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148672803","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":"Risk factors for sedation-related adverse events during endoscopic ultrasound.","authors":"Patricia Abellán-Alfocea, Francisco Valverde-López, Juan Gabriel Martínez-Cara, Rita Jiménez-Rosales, Clara Heredia-Carrasco, Eduardo Redondo-Cerezo","doi":"10.20524/aog.2026.1018","DOIUrl":"10.20524/aog.2026.1018","url":null,"abstract":"<p><strong>Background: </strong>Complex endoscopic procedures such as endoscopic ultrasound (EUS) require higher doses of sedation, and thus carry a higher risk of adverse events compared to conventional endoscopy. This prospective cohort study assessed the safety of propofol sedation administered by non-anesthesiologists, and identified factors associated with sedation-related adverse events during EUS.</p><p><strong>Methods: </strong>A total of 2986 examinations were performed between January 2011 and May 2019. We collected data on patient characteristics (including age, body mass index and American Society of Anesthesiologists [ASA] class), procedural details, and sedation-related outcomes. Procedure characteristics and sedation-related adverse events were compared, firstly between interventional and diagnostic EUS, and then based on body mass index, ASA class and age. Logistic regression was performed to search for independent risk factors for sedation-related adverse events.</p><p><strong>Results: </strong>Sedation-related complications occurred in 4.8% of patients, hypoxemia being the most frequent (3.8%). Obese patients exhibited the highest rates of hypoxemia, early discontinuation and bag-mask ventilation (29.6%, 22.2% and 11.1%, respectively). Multivariate analysis revealed that obesity (odds ratio [OR] 8.57, 95% confidence interval [CI] 3.62-20.28) and comorbidities (ASA III/IV) (OR 2.04, 95%CI 1.44-3.01) were independently associated with sedation-related adverse events, while age was not significant.</p><p><strong>Conclusions: </strong>Propofol sedation administered by non-anesthesiologists during EUS was safe, with low rates of adverse events, the vast majority of which were clinically insignificant. Comorbidities and obesity, but not age, were independent risk factors for sedation-related complications during EUS. Appropriate patient selection and adequate training of endoscopists are warranted to minimize the risks associated with sedation during EUS.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 1","pages":"63-70"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140595","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}