Eur J Gastroenterol Hepatol [JOURNAL]
Sun
200 papers
Endoscopic ultrasound features in predicting noncurative resection of endoscopic submucosal dissection in patients with rectal neuroendocrine neoplasms.
Wang X, Cao M, Ding X … +3 more , Liu Z, Liu A, Liu H
Eur J Gastroenterol Hepatol · 2025 Oct · PMID 40742279 · Full text
PURPOSE: To explore the factors influencing noncurative resection (NCR) in patients with rectal neuroendocrine neoplasms (R-NENs) on the basis of endoscopic ultrasonography (EUS) findings and to construct and validate a...
PURPOSE: To explore the factors influencing noncurative resection (NCR) in patients with rectal neuroendocrine neoplasms (R-NENs) on the basis of endoscopic ultrasonography (EUS) findings and to construct and validate a nomogram prediction model based on these factors. METHODS: This retrospective cohort study included 244 patients with pathologically confirmed R-NEN who underwent endoscopic submucosal dissection (ESD) at the Affiliated Hospital of Qingdao University between March 2016 and June 2023. The patients' EUS and clinical features were collected to identify independent factors influencing NCR following ESD. A nomogram prediction model was constructed, and its performance was evaluated with receiver operating characteristic (ROC) curve analysis. RESULTS: A larger tumor diameter, irregular borders, and submucosal involvement on EUS were identified as independent risk factors for NCR following ESD in patients with R-NENs. A nomogram model integrating these three predictors effectively predicted the occurrence of NCR. ROC curve analysis was used to compare the clinical predictive efficacy of the independent influencing factors and their combination. The results revealed that the area under the curve for the combination of factors was 0.791, with a sensitivity of 68.6% and specificity of 86.0%, indicating good clinical diagnostic value. The Hosmer-Lemeshow goodness-of-fit test ( P = 0.178) indicated satisfactory model calibration. CONCLUSION: The nomogram model achieved good predictive performance. This model can assist endoscopists in dynamically assessing the risk of NCR in real time, but its clinical applicability requires verification.
Complement C3 predicting acute-on-chronic liver failure in cirrhotic patients with bacterial infection within 90 days: a cohort study.
Chen S, Li R, Liu H … +8 more , Feng X, Zhou H, Zeng W, Ren H, Xiong Q, Zhang C, Wang X, Yang Y
Eur J Gastroenterol Hepatol · 2025 Oct · PMID 40736508 · Full text
OBJECTIVE: Cirrhotic patients with bacterial infections (BI) face high risks of acute-on-chronic liver failure (ACLF) and mortality. This study assessed the diagnostic value of serum complement component 3 (C3) for predi...
OBJECTIVE: Cirrhotic patients with bacterial infections (BI) face high risks of acute-on-chronic liver failure (ACLF) and mortality. This study assessed the diagnostic value of serum complement component 3 (C3) for predicting 90-day ACLF and mortality in this population. METHODS: We prospectively analyzed clinical data from 105 cirrhotic patients with BI (mean age 57.2 ± 11.6 years; 57 male) admitted to the Second Hospital of Nanjing between September 2023 and March 2024. Primary outcomes were ACLF development and mortality within 90 days. RESULTS: Thirty-one patients (29.5%) developed ACLF within 90 days. Lower C3 levels independently predicted both ACLF [hazard ratio (HR): 0.14, 95% confidence interval (CI): 0.02-0.93; P = 0.04) and mortality (HR: 0.10, 95% CI: 0.00-0.89; P = 0.01). Time-dependent receiver operating characteristic analysis showed C3 predicted ACLF with AUROCs of 0.76 (30 day), 0.73 (60 day), and 0.72 (90 day). For mortality, areas under the time-dependent receiver operating characteristic curves (AUROCs) were 0.76 (30 day), 0.69 (60 day), and 0.68 (90 day). A cutoff of 0.66 g/L was established using etiology-adjusted restricted cubic spline. C3 correction improved the predictive AUROCs of Child-Turcotte-Pugh, Model of End-Stage Liver Disease, and the Chronic Liver Failure Consortium Acute Decompensation scores for mortality (all P > 0.05). Random forest regression identified C3 among the top 10 risk factors for ACLF development. CONCLUSION: Serum C3 demonstrates significant prognostic value as a predictor for 90-day ACLF and mortality in cirrhotic patients with bacterial infections, offering potential clinical utility in risk stratification.
Safety and effectiveness of transient ascites drainage in hospitalized patients with large ascites.
Petzold G, Graw G, Delistefani F … +5 more , Knoop RF, Sasse A, Ellenrieder V, Neesse A, Amanzada A
Eur J Gastroenterol Hepatol · 2025 Dec · PMID 40690328 · Publisher ↗
OBJECTIVES: Single paracentesis is the standard treatment for large ascites. An alternative is the placement of a transient ascites drainage. This study aimed to evaluate the efficacy and safety of transient ascites drai...
OBJECTIVES: Single paracentesis is the standard treatment for large ascites. An alternative is the placement of a transient ascites drainage. This study aimed to evaluate the efficacy and safety of transient ascites drainage in patients with large ascites. METHODS: Patients with symptomatic ascites who underwent transient ascites drainage between January 2017 and February 2022 were enrolled in this study. The amount of drained ascites and the duration of the drainage stay were recorded. Drainage-associated acute complications have been documented. Risk factors for complications were analyzed. RESULTS: A total of 224 ascites drains were inserted into 177 patients. The mean cumulative volume of drained ascites was 14 284 ml (±9987). The duration of drainage varied between 0 and 42 days and averaged 8.57 days (±6.51). The technical success rate of drain placement was 98.21% (220/224). The most common drainage-associated complications were acute kidney injury in 31/224 (13.84%), bacterial peritonitis 16/185 (8.65%), and drainage-associated fistula [21/224 (9.38%)]. There were significant differences between the groups with and without drainage-associated peritonitis in the duration of drainage stay [13.63 (±8.13) vs. 8.06 (±6.20) days; P = 0.001). The frequency of peritonitis with a length of drainage stay of up to 7 days was 1.92%, with a length of stay greater than 7 days 17.28% ( P < 0.001). CONCLUSION: Transient ascites catheters are effective for the drainage of large-volume ascites. The technical success rate was high, and the procedure itself was safe; however, owing to the high rate of drainage-associated peritonitis, a longer duration of drainage should be avoided.
Transient elastography can stratify patients with Child Pugh A cirrhosis according to long-term risk of decompensation: a longitudinal cohort study.
Armstrong P, Moriarty A, Dillon A … +3 more , Galvin Z, Russell J, Stewart S
Eur J Gastroenterol Hepatol · 2026 Jan · PMID 40690327 · Publisher ↗
OBJECTIVE: There are no robust noninvasive tools to predict long-term liver-related events in well-compensated cirrhosis. We assessed the performance of noninvasive fibrosis tools in predicting decompensation, hepatocell...
OBJECTIVE: There are no robust noninvasive tools to predict long-term liver-related events in well-compensated cirrhosis. We assessed the performance of noninvasive fibrosis tools in predicting decompensation, hepatocellular carcinoma (HCC), and liver-related mortality (LRM) within a mixed aetiology Child Pugh A cirrhosis cohort. DESIGN: Patients were followed in a single centre for 10 years. The primary outcome was decompensation (ascites, encephalopathy, or variceal bleeding). Secondary outcomes were HCC and LRM. All patients received baseline transient elastography for liver stiffness measurement (LSM) and blood tests to calculate Fibrosis-4 (FIB-4). RESULTS: In 114 patients, 31% decompensated during the follow-up period. 11% developed HCC. Increased LSM is associated with greater decompensation risk ( P = 0.007). When controlling for FIB-4 and alcohol consumption, for each 1 kPa increase, the 10-year risk of decompensation increased by 2.2% [ P = 0.009, hazard ratio: 1.022, 95% confidence interval (CI): 1.01-1.04]. Ten-year risk of decompensation was 20% for LSM < 21 kPa, 32% in the 21-35 kPa group, and 47% in the ≥35 kPa group ( P = 0.019). After censoring for HCC, index LSM was associated with risk of death or liver transplant [odds ratio (OR): 1.029 (95% CI: 1-1.06) P = 0.039]. FIB-4 is associated with HCC risk ( P = 0.001) with an OR: 1.16 (95% CI: 1.01-1.32). CONCLUSION: Ten-year risk of decompensation increased with increasing LSM in mixed aetiology compensated cirrhosis. LSM can be used to risk-stratify real-world patients, in order to reassure those at lowest risk and potentially focus resources on patients with higher scores and greatest decompensation risk.
Clinical characteristics and long-term outcomes among inflammatory bowel disease patients of different ethnic groups: a case-control study.
Ealiwa N, Alamour W, Abu-Tailakh M … +4 more , Eraki L, Abu-Kaf H, Weissmann S, Abu-Freha N
Eur J Gastroenterol Hepatol · 2026 Jan · PMID 40690326 · Publisher ↗
INTRODUCTION: Inflammatory bowel disease (IBD) causes chronic inflammation in the gastrointestinal tract, particularly in the colon and small intestine. We aimed to compare the clinical characteristics and long-term outc...
INTRODUCTION: Inflammatory bowel disease (IBD) causes chronic inflammation in the gastrointestinal tract, particularly in the colon and small intestine. We aimed to compare the clinical characteristics and long-term outcomes of Arab Bedouin and Jewish IBD patients in the Negev. METHODS: This retrospective case-control study (1:2 matching, controlled for age and sex) included patients of Bedouin Arab (BA) or Jewish origin, aged 18 or older, diagnosed with Crohn's disease (CD) or ulcerative colitis (UC). Data on demographics, disease behavior, outcomes, and mortality were collected. RESULTS: One hundred sixty-seven CD patients and 159 UC patients were included. Fifty-eight (34.7%) of the CD patients and 53 (33.3%) of the UC patients were BA. BA CD patients had a higher proportion of ileal disease (56.9 vs. 35.8%, P = 0.009), and lower healthcare utilization, including fewer emergency department visits (9.4 ± 8.7 vs. 16.2 ± 13.8, P < 0.001) and fewer hospitalizations (5.18 ± 6 vs. 12.2 ± 12, P < 0.001) than Jewish patients. Treatment disparities showed that AB patients were less likely to receive biological therapies (55.2 vs. 84.4%, P < 0.001). Regarding UC, AB patients had a higher rate of proctitis than Jewish patients (56.6 vs. 29.2%, P < 0.001) and a higher rate of extraintestinal manifestations 41.5 vs. 11.3%, P < 0.001, respectively. In addition, BA UC patients had a lower rate of biological treatment but a higher rate of hospitalization and death. CONCLUSION: The study underscores the need for tailored healthcare strategies for BA IBD patients, including improved healthcare access, financial and social support, and culturally sensitive educational initiatives.
Sex disparity in hepatocellular carcinoma recurrence after curative liver resection: a multicenter comprehensive analysis.
Dai MG, Liu SY, Xu Q … +5 more , Lu WF, Liang L, Liu JW, Zhang K, Ye B
Eur J Gastroenterol Hepatol · 2025 Nov · PMID 40631508 · Publisher ↗
BACKGROUND AND AIMS: The impact of sex disparity on the patterns of recurrence after curative resection of hepatocellular carcinoma (HCC) remains controversial. The aim of this study was to comprehensively investigate th...
BACKGROUND AND AIMS: The impact of sex disparity on the patterns of recurrence after curative resection of hepatocellular carcinoma (HCC) remains controversial. The aim of this study was to comprehensively investigate the influence of sex differences in HCC recurrence following curative hepatectomy. METHODS: Patients who underwent curative-intent resection for HCC between July 2015 and June 2020 were identified from a multicenter database and analyzed retrospectively. Tumor recurrence was evaluated using Cox regression and Kaplan-Meier methods. Hazard curves representing the changes in risk of recurrence over time were evaluated. Propensity score matching and a competing risk model were used for sensitivity analysis. RESULTS: Of 1570 patients, 1334 (85.0%) were men, and 236 (15.0%) were women. Female patients showed significantly lower risk for HCC recurrence than males in the multivariate Cox regression analysis (hazard rate: 0.75, 95% confidence interval: 0.61-0.93, P = 0.008). Landmark analysis showed that sex was an independent risk factor for late recurrence, but not for early recurrence. The hazard function curve for female patients was relatively flat [peak hazard rates (pHR): 0.0234], while males recurred with a peak at 3.0 months (pHR: 0.0302). A lower risk of HCC recurrence was also found in females in the sensitive analysis. CONCLUSION: Male patients had a higher risk of HCC recurrence than females after surgery, and recurrence hazard rates for different sexes varied substantially with respect to both time and peak rates.
Significance of surgical resection and resection margins for hepatocellular carcinoma with microvascular invasion: a systematic review and meta-analysis.
Shi S, Cui X, Liu C … +2 more , Li H, Zhai R
Eur J Gastroenterol Hepatol · 2025 Nov · PMID 40631501 · Publisher ↗
OBJECTIVE: For hepatocellular carcinoma (HCC) with microvascular invasion (MVI), the choice of surgical resection (SR) and resection margins (RMs) remains to be determined. The aim of this study was to discuss the relati...
OBJECTIVE: For hepatocellular carcinoma (HCC) with microvascular invasion (MVI), the choice of surgical resection (SR) and resection margins (RMs) remains to be determined. The aim of this study was to discuss the relationship between SR and RM and MVI-positive HCC. METHODS: PubMed, Embase, Web of Science, and Cochrane Library were searched up to 1 September 2024. The methodological quality of eligible articles was assessed using the Newcastle-Ottawa Scale (NOS). Effect models were selected to pool the HR and 95% CI of recurrence and overall survival (OS) based on the presence of heterogeneity to assess the impact of SR and RM in MVI-positive HCC. RESULTS: A total of 12 articles with 6747 cases were included. NOS scale indicated that the studies were of high quality. The results showed that narrow RM were a risk factor for postoperative recurrence and OS in MVI-positive HCC, with a pooled HR of 1.76 (95% CI: 1.49, 2.07) and 1.99 (95% CI: 1.58, 2.49), respectively; whereas nonanatomical resection (NAR) was another risk factor for postoperative recurrence and OS, with a pooled HR of 1.33 (95% CI: 1.15, 1.54) and 1.42 (95% CI: 1.15, 1.75), so wide RM and anatomical resection (AR) was beneficial for postoperative recurrence and long-term survival. In the subgroups, narrow RM were more than twice the risk factor for TTR compared with wide RM; and in the SR subgroup, studies from the Japanese had more than double the risk factor for postoperative recurrence and OS compared with China. CONCLUSION: For HCC with MVI, treatment modalities recommending anatomical resection and wide margins will have beneficial effects on postoperative recurrence and long-term survival.
Differential association of platelet indices in NAFLD/NASH: a Mendelian randomized study.
Huang H, Bai Y, Zhao Y … +1 more , Sun X
Eur J Gastroenterol Hepatol · 2025 Dec · PMID 40631492 · Publisher ↗
OBJECTIVE: Platelets play important roles in thrombosis, immunity, and inflammation. Recent studies have shown a relationship between platelet indices and nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepat...
OBJECTIVE: Platelets play important roles in thrombosis, immunity, and inflammation. Recent studies have shown a relationship between platelet indices and nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH). However, the nature and direction of this causal relationship remain controversial. This study used two-sample Mendelian randomization (MR) to elucidate the potential causal relationships. METHODS: Genetic associations of platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) were obtained from the summary statistics of a genome-wide association study from the UK Biobank, those of NAFLD/NASH were sourced from the FinnGen database, and two different genome-wide association meta-analyses. Inverse variance weighting was conducted, with weighted median, Mendelian randomisation-Egger, and Mendelian randomisation Pleiotropy Residual Sum and Outlier methods used as sensitivity analyses. Estimates from the inverse variance weighting method were meta-analyzed. Reverse MR Analysis was conducted using NAFLD data. RESULTS: Increased genetically predicted PDW levels were consistently associated with increased NAFLD risk from all three sources (OR = 1.08, 95% CI = 1.01-1.15; P = 0.020). Genetically predicted NAFLD was associated with increased MPV (OR = 1.008, 95% CI: 1.005-1.032; P = 0.008). Increased levels of genetically predicted PDW were associated with an increased risk of NASH (OR = 1.603, 95% CI: 1.154-2.228; P = 0.005). Decreased levels of genetically predicted PLT and PCT were associated with an increased risk of NASH (OR = 0.679, 95% CI: 0.487-0.947, P = 0.023; OR = 0.587, 95% CI: 0.408-0.843; P = 0.004). CONCLUSION: Our results suggest that fluctuations in platelet indices are important in predicting the onset and progression of NAFLD/NASH.
Role of vessels encapsulating tumor clusters patterns in hepatocellular carcinoma: a literature review.
Wang M, Wang Y, Shen Y … +3 more , Cao L, Yan R, Lei J
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40631491 · Publisher ↗
Hepatocellular carcinoma (HCC) is one of the most common and highly lethal tumors worldwide. Early metastasis is the main cause of postoperative recurrence and high mortality in patients with HCC. Vessels encapsulating t...
Hepatocellular carcinoma (HCC) is one of the most common and highly lethal tumors worldwide. Early metastasis is the main cause of postoperative recurrence and high mortality in patients with HCC. Vessels encapsulating tumor clusters (VETCs) are a distinct vascular metastatic pattern different from microvascular invasion, which has higher recurrence and mortality rates because of its unique metastatic mechanism; however, VETC is currently recognized only by the morphological manifestations of pathology, while in-depth understanding and discussion are insufficient. In future clinical practice, VETC patterns may have a nonnegligible role in the prediction of HCC, therapeutic decision-making, and are closely related to the long-term survival and management of patients. In addition, there is unlimited research potential regarding the mechanism of VETC patterns. This paper summarizes VETC-positive HCC based on pathogenesis, diagnosis, prognosis, and treatment, and discusses current limitations and future prospects.
Letter to the editor regarding 'First-line anti-TNF agents, ustekinumab and vedolizumab perform similarly in Crohn's disease'.
Borrás-Blasco J, Valcuende-Rosique A, Cornejo S
Eur J Gastroenterol Hepatol · 2025 Aug · PMID 40575883 · Publisher ↗
Abstract loading — click title to view on PubMed.
Identification of high-risk group for diabetes-associated hepatocellular carcinoma using noninvasive test for liver fibrosis.
Kariyama K, Nouso K, Hiraoka A … +17 more , Toyoda H, Tada T, Tsuji K, Ishikawa T, Hatanaka T, Itobayashi E, Takaguchi K, Tsutsui A, Naganuma A, Yasuda S, Kakizaki S, Tada F, Ohama H, Wakuta A, Shiota S, Kumada T, Real-Life Practice Experts for HCC (RELPEC) Study Group
Eur J Gastroenterol Hepatol · 2025 Nov · PMID 40575827 · Publisher ↗
BACKGROUND: As diabetes-associated hepatocellular carcinoma (DM-HCC) has surged in Japan, there is an urgent need for effective screening methods. The Fibrosis-4 (FIB-4) index is commonly used for screening, but its age...
BACKGROUND: As diabetes-associated hepatocellular carcinoma (DM-HCC) has surged in Japan, there is an urgent need for effective screening methods. The Fibrosis-4 (FIB-4) index is commonly used for screening, but its age component tends to yield false-positive results in older patients. This study aimed to evaluate the value of the newly developed Fibrosis-3 (FIB-3) index, which excludes age, for identifying high-risk groups for DM-HCC across all age groups. METHODS: This study included 174 patients with diabetes-associated Barcelona Clinic Liver Cancer stage 0 hepatocellular carcinoma (HCC) and 74 diabetic controls. The ability of the FIB-4 and FIB-3 indices to predict HCC risk was assessed using receiver operating characteristic (ROC) curves and multivariate logistic regression analyses. RESULTS: Both indices effectively identified high-risk groups for DM-HCC (area under the ROC curve: FIB-4, 0.909; FIB-3, 0.911). Notably, the FIB-4 index required age-adjusted cutoffs, whereas a single cutoff FIB-3 maintained its predictive ability across all age groups. Multivariate analysis confirmed FIB-3 as an independent predictor of HCC risk even after adjusting for factors such as BMI, liver function tests, and tumor markers. CONCLUSION: The FIB-3 index is a promising tool for identifying high-risk groups for DM-HCC without age-dependent cutoffs, potentially enabling earlier diagnosis and better prognosis. Its ability to stratify risk consistently across age groups addresses the limitations of FIB-4.
Incidence of hepatitis C virus infection and associated determinants among men who have sex with men without HIV in Amsterdam, the Netherlands, between 2012 and 2021.
Hage K, Koole J, Boyd A … +8 more , Matser A, Davidovich U, Bakker M, van der Hoek L, Koopsen J, Rebers S, Schinkel J, Prins M
Eur J Gastroenterol Hepatol · 2025 Oct · PMID 40569250 · Full text
OBJECTIVE: To assess the hepatitis C virus (HCV) prevalence, incidence, and associated determinants among men who have sex with men (MSM) without HIV in Amsterdam, the Netherlands. METHODS: We used data from the Amsterda...
OBJECTIVE: To assess the hepatitis C virus (HCV) prevalence, incidence, and associated determinants among men who have sex with men (MSM) without HIV in Amsterdam, the Netherlands. METHODS: We used data from the Amsterdam Cohort Studies (2012-2021) to calculate the prevalence of past/current HCV infection at the first study visit and incidence rate of primary HCV infection during follow-up. We identified determinants associated with incident HCV infection using univariable Bayesian exponential survival models. Phylogenetic analysis was conducted to compare HCV sequences of MSM without HIV to those from MSM with HIV and those using HIV pre-exposure prophylaxis. RESULTS: A total of 926 MSM were included. At first visit, 2/926 (0.2%) had a past/current HCV infection. Among 891 participants contributing to 6083.30 person-years of follow-up, three incident HCV infections were observed (incidence rate = 0.05/100 person-years). These infections were observed between 2014 and 2018, and all participants had never used HIV pre-exposure prophylaxis. Incident infections were associated with receptive condomless anal sex, having 1-10 sexual partners vs. none, recent injecting drug use (IDU), ever IDU, and fisting, albeit there was substantial uncertainty for all determinants (i.e. 95% credible intervals included one). Phylogenetic analysis revealed that one HCV-RNA sequence was closely related to HCV sequences from MSM with HIV. CONCLUSION: While HCV infection is uncommon among MSM without HIV, the risk of infection seems to increase among those with specific behaviors. HCV screening for MSM without HIV should be focused on those reporting these behaviors.
Adherence to clinical and endoscopic standards of quality in inflammatory bowel disease: a nationwide survey from the Italian Association of Hospital Gastroenterologists and Endoscopists.
Di Paolo MC, Cassinotti A, Pagnini C … +11 more , Ceccarelli L, Mocci G, Luppino I, Pumpo R, Antonelli E, Cappello M, Vassallo R, Comberlato M, Segato S, Bellini M, Soncini M
Eur J Gastroenterol Hepatol · 2025 Nov · PMID 40569217 · Publisher ↗
OBJECTIVE: Quality of care in inflammatory bowel disease (IBD) patients is a major priority as it is associated with better outcomes. We assessed the adherence of Italian gastroenterologists to current international reco...
OBJECTIVE: Quality of care in inflammatory bowel disease (IBD) patients is a major priority as it is associated with better outcomes. We assessed the adherence of Italian gastroenterologists to current international recommendations regarding quality performance measures for clinical and endoscopic IBD activities. METHODS: From March to July 2023, 179 Italian specialists participated in an online questionnaire-based survey concerning their demographic details, affiliations, clinical, and endoscopic practice. Data on the characteristics of the specialists' centres were also collected. Recommendations from European Crohn's and Colitis Organisation, Building Resources and Research in IBD Globally group, and European Society of Gastrointestinal Endoscopy for clinical and endoscopic standards were used as reference standards. RESULTS: Deviations from guidelines' recommendations included suboptimal availability of all specialties required for multidisciplinary teams, underuse of maintenance treatment with oral mesalamine in ulcerative colitis but still frequent use in Crohn's disease, suboptimal dosages of topical therapy, low attention to performing ileal biopsies in suspected IBD and to Paris and mucosal pattern classifications for lesion characterisation. No significant regional differences were observed, while significantly lower performances were reported for many responses coming from small centres or doctors less dedicated to IBD care. CONCLUSION: In Italy, adherence to current standards of care for IBD is generally good, with some practices to be improved. There is a need to support small centres and doctors less engaged in IBD within integrated clinical care networks.
Diagnostic accuracy of magnetically controlled capsule endoscopy for gastric conditions: a systematic review and meta-analysis.
Cui J, Wang Z, Li S … +1 more , Yu Z
Eur J Gastroenterol Hepatol · 2026 Jan · PMID 40569210 · Publisher ↗
Magnetically controlled capsule endoscopy (MCE) has emerged as a noninvasive alternative to esophagogastroduodenoscopy (EGD) for diagnosing gastric conditions. This review aimed to evaluate the diagnostic accuracy of MCE...
Magnetically controlled capsule endoscopy (MCE) has emerged as a noninvasive alternative to esophagogastroduodenoscopy (EGD) for diagnosing gastric conditions. This review aimed to evaluate the diagnostic accuracy of MCE compared to EGD. A comprehensive search of multiple databases was conducted to identify studies assessing the diagnostic accuracy of MCE against the reference standard of EGD. Ten studies comprising 1667 diagnostic units were included. Pooled sensitivity, specificity, likelihood ratios, and the diagnostic odds ratio (DOR) were calculated using a random-effects model. Heterogeneity was assessed using the I2 statistic, and publication bias was evaluated using Deek's funnel plot asymmetry test. The pooled sensitivity and specificity of MCE were both 0.92 [95% confidence interval (CI): 0.84-0.96 and 0.69-0.98, respectively]. The area under the receiver operating characteristic curve was 0.96 (95% CI: 0.94-0.97), indicating excellent diagnostic performance. The pooled positive likelihood ratio was 11.3, and the negative likelihood ratio was 0.09. The DOR was 129 (95% CI: 18-941). Substantial heterogeneity was observed ( I2 = 97%). No publication bias was detected ( P = 0.18). MCE demonstrates high diagnostic accuracy comparable to EGD for detecting gastric conditions, suggesting it could be an effective noninvasive alternative in specific clinical settings. However, significant interstudy variability in specificity warrants further investigation and standardization. Future research should focus on optimizing its clinical use and assessing its cost-effectiveness.
Risk of postcolonoscopy colorectal cancer following single-session endoscopic polypectomy: a retrospective cohort study using nationwide claims data.
Honda M, Takayama A, Yoshida S … +1 more , Kawakami K
Eur J Gastroenterol Hepatol · 2025 Sep · PMID 40530522 · Publisher ↗
OBJECTIVE: Colonoscopy is essential for colorectal cancer prevention. In Japan, two primary strategies for polypectomy are employed: single-session polypectomy, which combines diagnostic and therapeutic procedures in a s...
OBJECTIVE: Colonoscopy is essential for colorectal cancer prevention. In Japan, two primary strategies for polypectomy are employed: single-session polypectomy, which combines diagnostic and therapeutic procedures in a single session, and deferred polypectomy, which is performed after a diagnostic colonoscopy. However, the impact of different polypectomy strategies remains unclear. This study aimed to investigate this evidence gap by comparing the postcolonoscopy colorectal cancer (PCCRC) incidence between the two strategies. METHODS: This retrospective cohort study used data from the Japan Medical Data Center claims database. Patients aged 40-70 years who underwent initial therapeutic colonoscopy between April 2012 and December 2018 were included. The primary outcome was the incidence of PCCRC during the 4-year follow-up period. For primary analysis, the weighted hazard ratio (HR) was calculated using the Cox hazard model with inverse probability of treatment weighting (IPTW) and inverse probability of censoring weighting (IPCW). RESULTS: Among the 86 016 patients included, 71 027 were assigned to the single-session polypectomy group and 14 989 were assigned to the deferred polypectomy group. The incidence rates of PCCRC were 0.46 and 0.34 per 1000 person-years in the single-session and deferred polypectomy groups, respectively. The weighted HR with IPTW and IPCW in the single-session polypectomy group was 2.61 (95% confidence intervals: 1.25-5.44) compared to the deferred polypectomy group. CONCLUSION: This study provides the first large-scale evidence that single-session polypectomy is associated with a higher risk of PCCRC compared to deferred polypectomy. Our findings highlight the need to improve diagnostic accuracy during therapeutic colonoscopy and further optimize single-session polypectomy techniques.
Nutrition and the pancreas.
de Pretis N, Caldart F, Crucillà S … +7 more , Amodio A, De Marchi G, Campagnola P, Grasso T, Conti Bellocchi MC, Crinò SF, Frulloni L
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40530519 · Publisher ↗
The pancreas is a compound organ specialized in digestion and absorption of nutrients and in glucose homeostasis. Indeed, the exocrine component produces digestive enzymes and bicarbonates involved in the duodenal and je...
The pancreas is a compound organ specialized in digestion and absorption of nutrients and in glucose homeostasis. Indeed, the exocrine component produces digestive enzymes and bicarbonates involved in the duodenal and jejunal digestion, whereas endocrine cells, mainly located in the islets of Langerhans, produce glucose-regulating hormones. These two different pancreatic functions are strictly and directly regulated by mechanisms that are still not completely understood. Not only pancreatic secretions but also the interaction between exocrine and endocrine pancreatic function have relevance on nutritional status, and there is increasing evidence that nutritional status impacts the prognosis of both inflammatory and pancreatic neoplastic diseases of the pancreas. Signs of malnutrition need to be investigated and identified in patients with pancreatic diseases to optimize the medical management and, potentially, to improve the clinical outcome. Considering the central role of the pancreas in the nutrition state, in this review, we aimed to report the current knowledge on pancreatic exocrine and endocrine functions and their relationship with diet, and the modifications and the impact on prognosis of the inflammatory and neoplastic diseases of the pancreas.
Attitudes of physicians managing inflammatory bowel disease toward alterations of liver function tests: an Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) survey.
Pugliese N, Bezzio C, Festa S … +15 more , Caprioli FA, Renna S, Savarino EV, Variola A, Fantini MC, Saibeni S, Orlando A, Pugliese D, Macaluso FS, Polverini D, Dal Buono A, Gabbiadini R, Loy L, Aghemo A, Armuzzi A
Eur J Gastroenterol Hepatol · 2025 Aug · PMID 40530515 · Publisher ↗
BACKGROUND: Liver diseases are common in patients with inflammatory bowel disease (IBD). Little is known about how specialists perceive and manage liver enzyme abnormalities. This study investigates the current practice...
BACKGROUND: Liver diseases are common in patients with inflammatory bowel disease (IBD). Little is known about how specialists perceive and manage liver enzyme abnormalities. This study investigates the current practice and educational needs of IBD specialists in the management of liver enzyme abnormalities. METHODS: A 22-question web-based survey was distributed to members of the Italian Group for the study of IBD, covering their demographics, workplace features, and approaches to managing liver enzyme abnormalities in IBD patients. RESULTS: The survey was completed by 205/439 (46.7%) respondents. The majority of respondents were over 45 years old (38.5%) and worked in Northern Italy (61%). Most were gastroenterologists (86%) practicing in public hospitals (45%), with 21.5% having a defined referral pathway to a dedicated liver unit for IBD patients. Ninety-seven percent of physicians reported regular monitoring of transaminases, while 88% also monitored gamma-glutamyl transpeptidase and 76% alkaline phosphatase (ALP). In cases of abnormal enzyme levels, over 70% reported ordering additional diagnostic tests independently, with notable heterogeneity in the thresholds used to trigger further investigation. The conditions most frequently suspected in cases of mild transaminase elevations were metabolic dysfunction-associated steatotic liver disease (71%) and drug-induced liver injury (17%). A significant proportion of physicians (57%) considered their training in managing liver enzyme abnormalities adequate but acknowledged the need for further educational opportunities. The main barrier identified was the lack of specific guidelines and actionable flowcharts (62%). CONCLUSION: This survey reveals heterogeneity in monitoring and management of liver enzyme abnormalities among IBD specialists. Most physicians recognize the need for improved training and specific guidelines.
Outcomes of acute severe ulcerative colitis at initial presentation.
Couto Sousa D, Fernandes SR, Saraiva S … +4 more , Gonçalves AR, Valente A, Moura Santos P, Correia L
Eur J Gastroenterol Hepatol · 2025 Sep · PMID 40530512 · Publisher ↗
BACKGROUND: 20-25% of patients with ulcerative colitis (UC) will experience at least one episode of acute severe ulcerative colitis (ASUC). Up to 20% of nonresponders to medical treatment require surgery during the index...
BACKGROUND: 20-25% of patients with ulcerative colitis (UC) will experience at least one episode of acute severe ulcerative colitis (ASUC). Up to 20% of nonresponders to medical treatment require surgery during the index episode. For approximately one-third of the patients, ASUC is the first manifestation of the disease, presenting unique challenges. METHODS AND AIMS: Retrospective cohort study including 185 patients hospitalized with ASUC. We aim to compare the clinical outcomes between patients with new-onset and established UC. RESULTS: 62 (33.5%) patients had new-onset, while 123 (66.5%) had established UC. Demographic and baseline clinical characteristics were similar between groups. Patients with new-onset UC experienced longer hospitalizations (19 ± 22 vs. 12 ± 11 days; P = 0.002), longer delay until receiving rescue therapy [11 vs. 6 days (interquartile range : 6-8 days); P = 0.014] and more severe bacterial infections (16 vs. 4%; P = 0.005). We found no significant differences in steroid response ( P = 0.719), need for rescue therapy ( P = 0.522), response to rescue therapy ( P = 0.234), colectomy ( P = 0.655), mortality ( P = 0.516), and hospital readmission ( P = 0.929) between groups. After 1 year, colectomy or death occurred in 13.5% of patients. Independent predictors of adverse outcomes included active smoking, extensive colitis, the need for rescue therapy, and severe bacterial infections - but not new-onset disease. CONCLUSION: Major clinical outcomes were similar between patients with new-onset and established UC.
Endoscopic retrograde cholangiopancreatography discharge tool combined with rapid trypsinogen-2 test to predict same-day discharge: a prospective cohort study.
Sperna Weiland CJ, Engels MML, Scheffer RCH … +7 more , Van Balkom B, van Hee K, Haarhuis BJT, Drenth JPH, van Hooft JE, Siersema PD, van Geenen EJM
Eur J Gastroenterol Hepatol · 2025 Nov · PMID 40530510 · Full text
OBJECTIVES: Identifying patients at high-risk for endoscopic retrograde cholangiopancreatography (ERCP)-related adverse events (AEs) is important for postendoscopic discharge management. This study assesses two strategie...
OBJECTIVES: Identifying patients at high-risk for endoscopic retrograde cholangiopancreatography (ERCP)-related adverse events (AEs) is important for postendoscopic discharge management. This study assesses two strategies, a urinary trypsinogen-2 (UT-2) dipstick combined with a risk-factor-based ERCP discharge tool, for identifying patients at increased risk of developing AEs. METHODS: Between August 2018 and March 2021, 268 patients were enrolled in a multicenter prospective cohort. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the UT-2 dipstick, the discharge tool, and combined strategies were assessed for predicting ERCP-related AEs. RESULTS: Twenty-four (10.5%) AEs occurred in the eligible 228 patients, of which 14 (6.1%) were post-ERCP pancreatitis. The discharge tool and UT-2 dipstick combination outperformed the individual strategies for all AEs with a sensitivity of 66.7% (95% CI, 44.7-84.4%), specificity of 78.5% (95% CI, 72.2-83.9%), PPV of 26.6% (95% CI, 19.8-34.8%) and NPV of 95.3% (95% CI, 91.9-97.3%). For post-ERCP pancreatitis alone, the strategies combined had a sensitivity of 64.3% (95% CI, 35.1-87.2%), specificity of 76.2% (95% CI, 69.9-81.7%), PPV of 14.9% (95% CI, 10.0-21.7%) and NPV of 97.0% (95% CI, 94.2-98.5%). CONCLUSION: Although the combination of UT-2 dipstick and discharge tool outperforms the two strategies separately in predicting post-ERCP AEs, we would not recommend implementation of either strategy given the low sensitivity when applied separately or combined.
Hepatotoxicity associated with vedolizumab: case report in a patient with ulcerative colitis.
Crosewski NI, Pereira AHM, Kotze LR … +5 more , Pedroso MLA, Kampa KC, Rosevics L, Furlan TK, Junior OR
Eur J Gastroenterol Hepatol · 2025 Aug · PMID 40530502 · Publisher ↗
Vedolizumab is a humanized antiintegrin α4β7 mAb, selective for the intestine, used in the treatment of moderate to severe inflammatory bowel disease. Safety studies show that vedolizumab has a 31% risk of serious advers...
Vedolizumab is a humanized antiintegrin α4β7 mAb, selective for the intestine, used in the treatment of moderate to severe inflammatory bowel disease. Safety studies show that vedolizumab has a 31% risk of serious adverse events, but reports of hepatotoxicity are rare. Previous case descriptions show that the lesion is mainly cholestatic or mixed, but hepatocellular lesion can also occur. We report a case of vedolizumab-associated hepatotoxicity in a patient with ulcerative colitis who had no previous liver disease. After starting treatment with vedolizumab, the patient presented elevated transaminases and canalicular in a cholestatic pattern, with normal liver imaging. Due to the suspicion of underlying hepatopathies such as primary sclerosing cholangitis and autoimmune hepatitis (AIH), a biopsy was performed, which showed a lymphocytic inflammatory infiltrate with lymphoid aggregates and eosinophils and plasma cells, as well as interface activity with 'spill-over' of lymphocytes to the parenchyma, which was interpreted as a lesion secondary to the drug. Discontinuation of vedolizumab led to a gradual improvement in liver tests. The case highlights the importance of monitoring liver tests in patients being treated with vedolizumab and the need to differentiate drug hepatotoxicity from other liver diseases.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe