Journal of gastrointestinal and liver diseases : JGLD最新文献

{"title":"The Yield of Prioritization of Gastrointestinal Endoscopy Activities According to the European Society of Gastrointestinal Endoscopy Recommendations.","authors":"Rachel Gingold-Belfer, Alon Ikan Amam, Igor Bouguslavskly, Yelena Chechulin, Doron Boltin, Zohar Levi, Maya Aharoni Golan","doi":"10.15403/jgld-5949","DOIUrl":"https://doi.org/10.15403/jgld-5949","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic procedures prioritization is an important tool for defining healthcare resources distribution in a daily practice and more important in times of limited resources such as the COVID 19 pandemic. We assessed the completion rate of endoscopic procedures that were canceled by the patients themself, based on the prioritization strategy recommended by the European Society of Gastrointestinal Endoscopy (ESGE) and examine what were the outcomes of the procedures' cancellation according to the endoscopic different indications.</p><p><strong>Methods: </strong>Retrospective analysis of all the self-cancelled procedures during March 2020 at our tertiary endoscopic referral center. The completion rate was estimated until July 2021. The procedure's primary indications were classified according to the ESGE position statement (\"always perform/high priority\" vs. \"low-priority/postpone always\"); Endoscopic findings were classified as \"significant\", defined as advanced neoplasia/ a clinically significant intervention, or \"other\".</p><p><strong>Results: </strong>We included 194 patients (mean age 60.4±15.3 years old; 44.8% females, 90.7% colonoscopies, 20.1% classified as \"always perform/ high priority\"). The completion rate in the \"perform always/high priority\" groups versus the \"low-priority/postpone always\" groups was 51.3% versus 70.3%, (p=0.024). In contrast, the rate of significant endoscopic findings in the \"perform always/high priority\" groups versus the \"low-priority/postpone always\" groups was 40.0% versus 7.3%, (p<0.001).</p><p><strong>Conclusions: </strong>Patients who are prioritized according to the ESGE classification have a higher rate of significant findings but a lower likelihood of completing the procedure. This highlights the need for improving implementation of prioritization strategy based on the ESGE classification.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 2","pages":"227-231"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Easy-to-use Non-invasive Scores in the Assessment of Hepatocellular Carcinoma Prognosis - Data from the Romanian Hepatocellular Carcinoma Registry.","authors":"Dana Crișan, Bogdan Procopeț, Rareș Crăciun, Horia Ștefănescu, Liana Gheorghe, Ioan Sporea, Larisa Daniela Săndulescu, Anca Trifan, Zeno Spârchez, Mirela Dănilă, Ion Rogoveanu, Răzvan Cerban, Camelia Cojocariu, Roxana Șirli, Cristiana Marinela Urhut, Călin Burciu, Lidia Ciobanu, Mihai Rătan, Tudor Cosma, Nadim Al-Hajjar, Mircea Grigorescu","doi":"10.15403/jgld-6114","DOIUrl":"10.15403/jgld-6114","url":null,"abstract":"<p><strong>Background and aims: </strong>Hepatocellular carcinoma (HCC) is currently the third leading cause of cancer-related mortality, a figure that is on the rise. The shared hallmark of different etiologies, progression, and HCC survival is chronic inflammation, making it a significant field of interest for prognostic and therapeutic strategies. We aimed to evaluate the prognostic accuracy of several inflammation-based scores in HCC.</p><p><strong>Methods: </strong>A consecutive series of patients at their first HCC diagnosis were enrolled during a 5-year timespan in a prospectively maintained multicentric database. Demographic, clinical, biological, and imagistic data were collected. Representative inflammation-based prognostic scores, including the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), systemic immune inflammation index (SII), prognostic nutritional index (PNI), albumin-to-bilirubin index (ALBI), platelet-albumin-bilirubin-index (PALBI), AST-to-lymphocyte ratio (ALRI), AST/ALT, AST-to-platelet ratio (APRI) were assessed for prediction of overall survival (OS) in a scenario-based setting, using Kaplan-Meier curves, univariate and multivariate analyses.</p><p><strong>Results: </strong>A total of 467 patients from five tertiary-care hospitals were enrolled in this study. The median age was 64.94 years, and the most frequent etiology of the liver disease was hepatitis C (50%). During a median of 14.85 (35) months of follow-up, the cumulative mortality was 84.8%. In the univariate analysis, PNI (HR=2.414; p=0.021), ALBI grade (HR=2.023; p<0.001), and PALBI grade (HR=2.022; p<0.001) demonstrated the highest prognostic accuracies for OS in HCC, regardless of the clinical scenario. Moreover, PLR (HR=1.635; p=0.002), ALRI (HR=1.555; p<0.001), NLR (HR=1.461; p=0.007), AST/ALT (HR=1.420; p=0.012), and APRI (HR=1.356; p=0.009) were also significant prognostic factors for OS. The multivariate analysis showed that only ALBI grade (HR=1.974; p<0.001), SII (HR=1.487; p=0.009), and PLR (HR=1.647; p=0.014) were independently associated with OS.</p><p><strong>Conclusions: </strong>Inflammation-based scores allow for an accurate prediction of survival in HCC. Their ability to predict the response to treatment and complications merits further investigation.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 2","pages":"205-213"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Comparison of Initial vs. Subsequent Simultaneous Side-by-Side Stenting with Uncovered Metal Stents during Endoscopic Retrograde Cholangiopancreatography for Unresectable Malignant Hilar Biliary Obstructions.","authors":"Koji Takahashi, Hiroshi Ohyama, Motoyasu Kan, Mayu Ouchi, Hiroki Nagashima, Kohichiroh Okitsu, Izumi Ohno, Naoya Kato","doi":"10.15403/jgld-5933","DOIUrl":"https://doi.org/10.15403/jgld-5933","url":null,"abstract":"<p><strong>Background and aims: </strong>This study aimed to evaluate the efficacy and safety of transpapillary simultaneous side-by-side (SBS) stenting using uncovered self-expandable metal stents (UCSEMSs) at the initial endoscopic retrograde cholangiopancreatography (ERCP) for unresectable malignant hilar biliary obstruction (UMHBO).</p><p><strong>Methods: </strong>A total of 67 patients with UMHBO who underwent simultaneous SBS stenting at our institution were retrospectively divided into two groups: the SBS stenting at the initial ERCP group (n=13) and the SBS stenting at the subsequent ERCP group (n=54). Clinical outcomes were compared between the groups.</p><p><strong>Results: </strong>There were no significant differences between the SBS stenting at the initial ERCP group and the SBS stenting at the subsequent ERCP group in procedural time (median: 50 vs. 40 minutes, p=0.31), functional success rate (69.2% vs. 83.3%, p=0.25), adverse event rate (30.8% vs. 14.8%, p=0.18), recurrent biliary obstruction (RBO) rate (23.1% vs. 38.9%, p=0.29), technical success rate of re-intervention (100% vs. 90.5%, p=0.58), cumulative time to RBO (not reached vs. 252 days, p=0.80), or median overall survival (73 vs. 212 days, p=0.12).</p><p><strong>Conclusions: </strong>Simultaneous SBS stenting using UCSEMSs at the initial ERCP is a safe and effective strategy for managing UMHBO, with outcomes comparable to those of SBS stenting performed at the subsequent ERCP.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 2","pages":"214-219"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Cause of Acute Gastrointestinal Haemorrhage: Bleeding Gastric Diverticulum.","authors":"Matthew Peverelle, Benhur Reynauld","doi":"10.15403/jgld-5847","DOIUrl":"https://doi.org/10.15403/jgld-5847","url":null,"abstract":"","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 2","pages":"151"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibrosis Regression of Advanced Chronic Liver Disease Outlined by a Novel Histological Classification.","authors":"Muriel Ducousso, Matteo Montani, Jaime Bosch, Annalisa Berzigotti, Yuly Paulin Mendoza","doi":"10.15403/jgld-6018","DOIUrl":"https://doi.org/10.15403/jgld-6018","url":null,"abstract":"<p><p>In the past, advanced chronic liver disease was considered irreversible, but with better understanding and improved treatments, it is now recognized that fibrosis is a dynamic process that can regress even when it has reached the stage of cirrhosis. We present the case of a 60-year-old male patient with advanced chronic liver disease due to chronic hepatitis B, whose follow-up liver biopsy revealed significant fibrosis regression after successful antiviral therapy. We confirmed the predominantly regressive pattern using the P-I-R classification, a new histological classification that defines the tissue features as predominantly \"Progressive, Intermediate or Regressive\" by comparing stroma to parenchymal ratios. Furthermore, we also point out the prognostic value of P-I-R classification, as the patient has remained free of decompensation over time. In this clinical case, we highlight important aspects of the pathophysiology and histopathology of cirrhosis regression, emphasizing its critical prognostic significance. Finally, familiarizing clinicians and pathologists with the application of the P-I-R classification may improve prognostication based on histology in patients with advanced liver disease.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 2","pages":"256-259"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Plastic Stent for the Treatment of Incomplete Clearance of Common Bile Duct Stone: A Systematic Review and Meta-analysis.","authors":"Marco Valvano, Antonio Vinci, Filippo Antonini, Amedeo Montale, Annalisa Capannolo, Stefano Fabiani, Gianpiero Stefanelli, Marco Magistroni, Marta Mosca, Susanna Faenza, Fabio Ingravalle, Mariachiara Campanale, Maurici Massimo, Giovanni Latella","doi":"10.15403/jgld-5964","DOIUrl":"10.15403/jgld-5964","url":null,"abstract":"<p><strong>Background and aims: </strong>Common bile duct stones (CBDs) can typically be treated by endoscopic retrograde cholangiopancreatography (ERCP) in 85-90% of cases. However, in the remaining 10-15% of patients, bile duct stones cannot be extracted. In such cases, the placement of a temporary biliary plastic stent is recommended.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis (PROSPERO registration number: CRD42023459712; October 2023). An electronic search was carried out using the following databases: PubMed/MEDLINE, Scopus, and CENTRAL (last search: October 20, 2023). All published studies (both randomized clinical trials and non-randomized interventional studies) involving patients who had undergone ERCP for CBDs with incomplete biliary clearance were included. The risk of bias was assessed using the RoB 2.0 and ROBINS-I tools. The confidence in network meta-analysis tool was employed to estimate each study's contribution matrix within the network estimate.</p><p><strong>Results: </strong>Twenty papers (comprising 902 patients) were selected for qualitative and quantitative synthesis and were included in the standard meta-analysis, while only five studies (254 patients) were used for the network meta-analysis. The pooled success rate of stenting intervention in difficult choledocholithiasis was 79% (95% CI:71-87%). In the network meta-analysis model, ursodeoxycholic acid and single or double stenting resulted in a higher probability of being the most effective treatments.</p><p><strong>Conclusions: </strong>In cases of incomplete CBD clearance, the insertion of a temporary plastic stent achieves complete clearance in 79% of patients. Although not significantly superior in indirect comparison with stent alone, the adjunctive treatment with ursodeoxycholic acid appears to be the most likely to succeed.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 2","pages":"232-240"},"PeriodicalIF":2.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Sided Diaphragmatic Eventration: A Rare Cause of Recurrent Vomiting.","authors":"Sanjeev Sachdeva, Ravi Teja Reddy, Kartik Mehta, Aarushi Ahuja","doi":"10.15403/jgld-5976","DOIUrl":"https://doi.org/10.15403/jgld-5976","url":null,"abstract":"","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 2","pages":"153"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic Malignant Melanoma: A Case Possibly Originating from the Duodenum.","authors":"Omer Kucukdemirci, Asli Akcay, Yakup Baris Sancar, Hasan Eruzun, Ufuk Avcioglu","doi":"10.15403/jgld-5927","DOIUrl":"https://doi.org/10.15403/jgld-5927","url":null,"abstract":"","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 2","pages":"154"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Helicobacter pylori and its Association with Extragastric Diseases in a Tertiary Hospital from East Bavaria.","authors":"Lisa Lipp, Stephan Schmid, Sophia Rusch, Peter Malfertheiner, Martina Müller, Michael Selgrad","doi":"10.15403/jgld-6107","DOIUrl":"https://doi.org/10.15403/jgld-6107","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori (H. pylori) infection remains a significant burden in gastroduodenal diseases. However, contemporary data on the prevalence of H. pylori infection in Germany are limited.</p><p><strong>Aim: </strong>This study aimed to evaluate the current seroprevalence of H. pylori infection in the East Bavarian region by analyzing antibody levels in patients presenting to a German university hospital.</p><p><strong>Methods: </strong>Serum samples were collected from both inpatients and outpatients of a German university hospital. H. pylori antibody concentrations were measured using a commercially available assay.</p><p><strong>Results: </strong>The overall prevalence of H. pylori infection was 24.8% (78/314), with the highest infection rates observed in individuals aged over 60 years. A significant association was found between H. pylori infection and liver cirrhosis, with a prevalence of 36.4% (36/99) in patients with liver cirrhosis compared to 19.5% (42/215) in those without liver cirrhosis (p = 0.002). No significant associations were observed between H. pylori infection and type 2 diabetes or coronary artery disease.</p><p><strong>Conclusion: </strong>This study highlights a low prevalence in H. pylori seropositivity in the eastern part of Bavaria. In patients with liver cirrhosis, we still see a considerable high prevelance of H. pylori. The findings underscore the importance of continued surveillance to monitor trends in H. pylori prevalence and its associations with extragastric diseases.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 2","pages":"163-166"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pseudomelanosis Gastri: The Dark Side of Antihypertensives.","authors":"William King, Arvin Daneshmand, Neha Gupte, Charles Middleton, Anil Sharma","doi":"10.15403/jgld-6076","DOIUrl":"https://doi.org/10.15403/jgld-6076","url":null,"abstract":"","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 2","pages":"152"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}