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Laparoscopic liver resection utilizing the ventral avascular area of the inferior vena cava:A retrospective cohort study

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World Journal of gastroenterology 2025年第1期31卷 42-57页

作者： Kun Huang Zhu Chen Heng Xiao Hai-Yang Hu Xing-Yu Chen Cheng-You Du Xiang Lan department of Hepatobiliary surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400000China department of general surgery Mianyang Hospital of Traditional Chinese MedicineMianyang 621000Sichuan ProvinceChina

BACKGROUND Laparoscopic liver resection(LLR)can be challenging due to the difficulty of establishing a retrohepatic tunnel under *** the third hepatic hilum before parenchymal transection often leads to significant liver mobilization,tumor compression,and bleeding from the short hepatic veins(SHVs).This study introduces a novel technique utilizing the ventral avascular area of the inferior vena cava(IVC),allowing SHVs to be addressed after parenchymal transection,thereby reducing surgical complexity and improving outcomes in in situ *** To introduce and evaluate a novel LLR technique using the ventral avascular area of the IVC and compare its short-term outcomes with conventional *** The clinical cohort data of patients with pathologically confirmed hepatocellular carcinoma or intrahepatic cholangiocarcinoma who underwent conventional LLR and novel LLR between July 2021 and July 2023 at the First Affiliated Hospital of Chongqing Medical University were retrospectively *** novel LLR,we initially separated the caudate lobe from the IVC using dissecting forceps along the ventral avascular area of the ***,we transected the parenchyma of the left and right caudate lobes from the caudal side to the cephalic side using the avascular area as a ***,we addressed the SHVs and finally dissected the root of the right hepatic vein or left hepatic *** short-term postoperative outcomes and oncological results of the two approaches were evaluated and *** A total of 256 patients were included,with 150(58.59%)undergoing conventional LLR and 106(41.41%)undergoing novel *** novel technique resulted in significantly larger tumor resections(6.47±2.96 cm vs 4.01±2.33 cm,P<0.001),shorter operative times(199.57±60.37 minutes vs 262.33±83.90 minutes,P<0.001),less intraoperative blood loss(206.92±37.09 mL vs 363.34±131.27 mL,P<0.001),and greater resection volume(345.11±31.40 mL vs 264.38±31.98 mL,P<0.001)comp

关键词： Laparoscopic liver resection Inferior vena cava Retrohepatic tunnel Short hepatic veins Complex liver tumors Intraoperative bleeding control

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Redefining endoluminal biliary drainage:Challenges and innovations in endosonography-guided techniques

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World Journal of gastroenterology 2025年第1期31卷 146-151页

作者： Marcel Razpotnik department of gastroenterology and Hepatology Campus Virchow/Campus MitteCharitéBerlinBerlin 10117Germany

Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary ***,its use in complex biliary obstructions is *** the past decades,therapeutic endosonography(EUS)and emerging technologies such as lumen-apposing metal stents have enabled endoscopic treatment of conditions previously requiring nonendoscopic or surgical *** show that EUS-guided choledochoduodenostomy is a reliable alternative to endoscopic retrograde cholangiopancreatography in the treatment of distal malignant biliary obstructions and can be considered a primary drainage modality in centers with adequate *** malignant hilar biliary obstructions,draining at least 50%of viable liver tissue often requires combining different *** treatment strategy in these patients should be individualized,depending on the Bismuth classification,patient physical status,and intended systemic *** to the lack of evidence,general recommendations cannot be made for EUS-guided hepaticoduodenostomy or combined procedures with transhepatic bridging *** novel techniques should be limited to selected palliative cases where conventional methods have failed and conducted within clinical trials to generate evidence before broader application.

关键词： Endoscopic biliary drainage Interventional endosonography Lumen-apposing metal stent Malignant hilar biliary obstruction Malignant distal biliary obstruction

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Gut microbiota-astrocyte axis: new insights into age-related cognitive decline

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Neural Regeneration Research 2025年第4期20卷 990-1008页

作者： Lan Zhang Jingge Wei Xilei Liu Dai Li Xiaoqi Pang Fanglian Chen Hailong Cao Ping Lei Haihe Laboratory of Cell Ecosystem Department of GeriatricsTianjin Medical University General HospitalTianjinChina Tianjin Geriatrics Institute Tianjin Medical University General HospitalTianjinChina department of gastroenterology and Hepatology Tianjin Medical University General HospitalNational Key Clinical SpecialtyTianjin Institute of Digestive DiseasesTianjin Key Laboratory of Digestive DiseasesTianjinChina department of Urology Tianjin Medical University General HospitalTianjinChina Tianjin Neurological Institution Tianjin Medical University General HospitalTianjinChina

With the rapidly aging human population,age-related cognitive decline and dementia are becoming increasingly prevalent *** is considered the main risk factor for cognitive decline and acts through alterations in the composition of the gut microbiota,microbial metabolites,and the functions of *** microbiota–gut–brain axis has been the focus of multiple studies and is closely associated with cognitive *** article provides a comprehensive review of the specific changes that occur in the composition of the gut microbiota and microbial metabolites in older individuals and discusses how the aging of astrocytes and reactive astrocytosis are closely related to age-related cognitive decline and neurodegenerative *** article also summarizes the gut microbiota components that affect astrocyte function,mainly through the vagus nerve,immune responses,circadian rhythms,and microbial ***,this article summarizes the mechanism by which the gut microbiota–astrocyte axis plays a role in Alzheimer’s and Parkinson’s *** findings have revealed the critical role of the microbiota–astrocyte axis in age-related cognitive decline,aiding in a deeper understanding of potential gut microbiome-based adjuvant therapy strategies for this condition.

关键词： age aging Alzheimer’s disease astrocytes cognitive decline dementia gut microbiota gut–brain axis microbial metabolites neuroinflammation Parkinson’s disease

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Effect of cholesterol metabolism on hepatolithiasis

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World Journal of gastroenterology 2025年第1期31卷 157-162页

作者： Lin Zheng Zi-Yu Ye Jun-Ji Ma department of gastroenterology The Second Hospital of Hebei Medical UniversityHebei Key Laboratory of GastroenterologyHebei Institute of GastroenterologyHebei Clinical Research Center for Digestive DiseasesNo.215 Heping West RoadShijiazhuang 050000Hebei ProvinceChina

Surgical intervention is currently the primary treatment for hepatolithiasis;how-ever,some patients still experience residual stones and high recurrence rates after *** metabolism seems to play an important role in hepatoli-thiasis pathogenesis.A high cholesterol diet is one of the significant reasons for the increasing incidence of ***,regular diet and appropriate medical intervention are crucial measures to prevent hepatolithiasis and reduce recurrence rate after *** dietary cholesterol and drugs that increase cholesterol stone solubility are key therapeutic approaches in treating *** article discusses the cholesterol metabolic pathways related to the pathogenesis of hepatolithiasis,as well as food intake and targeted therapeutic drugs.

关键词： Hepatolithiasis Cholesterol metabolism High-fat diet 3-hydroxy-3-methylglutaryl-coenzyme A reductase Interlobular bile duct

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Endoscopic techniques for the diagnosis of pancreatic cystic lesions

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World Journal of gastroenterology 2025年第1期31卷 1-7页

作者： Sahib Singh Saurabh Chandan Rakesh Vinayek Jahnvi Dhar Jayanta Samanta Gabriele Capurso Ivo Boskoski Cristiano Spada Jorge D Machicado Stefano Francesco Crinò Antonio Facciorusso department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Division of gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States department of gastroenterology Sinai Hospital of BaltimoreBaltimoreMD 21215United States department of gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Division of Pancreato-Biliary Endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy Digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCSSUniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingRoma 00168Italy department of gastroenterology and Endoscopy Catholic UniversityRoma 00168Italy department of gastroenterology University of Michigan HealthAnn ArborMI 48107United States department of Endoscopy University of VeronaVerona 37121VenetoItaly gastroenterology Unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other *** accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced *** studies have reported varying diagnostic and adverse event rates with these *** addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different *** this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.

关键词： Endoscopic ultrasound Fine needle aspiration Needle confocal laser endomicroscopy Through-the-needle biopsy Contrast-enhanced endoscopic ultrasound

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Spectrum of venous thromboembolism in adult patients with ulcerative colitis in Pakistan:A single center retrospective study

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World Journal of Clinical Cases 2025年第6期13卷 9-13页

作者： Masood Muhammad Karim Hafsa Shaikh Faisal Wasim Ismail department of Medicine The Aga Khan University HospitalKarachi 74800Pakistan department of general surgery The Aga Khan University HospitalKarachi 74800Pakistan

BACKGROUND Patients with inflammatory bowel disease are at a 2-8-fold higher risk of deve-loping venous thromboembolism(VTE)as compared to the general *** the exact pathogenesis is unclear,the literature suggests that increased risk of thromboembolic events in such patients occurs as a result of increased coagulation factors,inflammatory cytokines,and reduction in anticoagulants leading to a prothrombotic *** To assess the prevalence,risk factors,management,and outcome of ulcerative colitis(UC)patients who develop *** This was a retrospective chart review done in The gastroenterology department of The Aga Khan University *** was collected from medical records for all patients admitted with a diagnosis of UC from January 2012 to December *** Seventy-four patients fulfilled the inclusion *** mean±SD of age at presentation of all UC patients was 45 years±10 years whereas for those who developed VTE,it was 47.6 years±14.7 *** and diabetes were the most common co-morbid seen among UC patients with a frequency of 17(22.9%)and 12(16.2%),respectively.A total of 5(6.7%)patients developed *** venous thrombosis was the most common thromboembolic phenomenon seen in 3(60%)*** the patients with UC and concomitant VTE were discharged home(5;100%).CONCLUSION The prevalence of VTE with UC in Pakistani patients corresponds with the international ***,multi-centric studies are required to further explore these results.

关键词： Deep venous thrombosis Inflammatory bowel disease Low-middle-income country Anticoagulation Protein C deficiency

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Real-world evidence on the efficacy and safety of vonoprazanamoxicillin dual therapy for Helicobacter pylori treatment in elderly patients

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World Journal of gastroenterology 2025年第1期31卷 68-78页

作者： Wen Gao Jing-Wen Li Hui Ye Xue-Zhi Zhang Jian-Xiang Liu Hong Cheng department of gastroenterology Peking University First HospitalBeijing 100034China School of Medicine Tsinghua MedicineTsinghua UniversityBeijing 100034China department of Traditional Chinese Medicine and Integrative Medicine Peking University First HospitalBeijing 100034China

BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(***).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly *** To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for *** in elderly *** As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for *** eradication in the department of gastroenterology at Peking University First Hospital between June 2020 and January *** status was evaluated by^(13)C-urease breath test 6 weeks after *** adverse events(AEs)during treatment were *** In total,401 cases were ***-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take *** total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue *** was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment *** overall incidence of AEs was 9.5%for both ***,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment *** patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE *** The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.

关键词： Helicobacter pylori Vonoprazan Amoxicillin Dual therapy Elderly

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Pancreatic stent improves the success rate of needle-knife papillotomy in patients with difficult biliary cannulation

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World Journal of gastroenterology 2025年第1期31卷 58-67页

作者： Mu-Hsien Lee Cheng-Hui Lin Chi-Huan Wu Yung-Kuan Tsou Kai-Feng Sung Sheng-Fu Wang Nai-Jen Liu department of gastroenterology and Hepatology Chang Gung Memorial Hospital and Chang Gung University College of MedicineTaoyuan 33305Taiwan School of Medicine Chang Gung UniversityTaoyuan 33305Taiwan

BACKGROUND Needle-knife precut papillotomy(NKP)is typically performed ***,it remains unclear whether pancreatic stent(PS)placement can improve the outcomes of *** To explore whether PS placement improves the success rate of NKP in patients with difficult biliary *** This single-center retrospective study included 190 patients who underwent NKP between January 2017 and December 2021 after failed conventional biliary *** cases with incidental pancreatic duct cannulation during conventional biliary cannulation,the decision for pre-NKP PS placement was made at the endoscopist's *** primary outcome was the difference in the NKP success rate between patients with and without PS placement;the secondary outcome was the adverse event *** Among the 190 participants,82 received pre-NKP PS(PS-NKP group)whereas 108 did not[freehand or freehand NKP(FH-NKP)group].Post-NKP selective biliary cannulation was successful in 167(87.9%)patients,and the PS-NKP had a significantly higher success rate than the FH-NKP group(93.9%vs 83.3%,P=0.027).The overall adverse event rates were 7.3%and 11.1%in the PS-NKP and FH-NKP groups,respectively(P=0.493).A periampullary diverticulum(PAD)and significant intraoperative bleeding during NKP were independently associated with NKP failure;however,a pre-NKP PS was the only predictor of NKP *** the 44 participants with PADs,the PS-NKP group had a non-significantly higher NKP success rate than the FH-NKP group(87.5%and 65%,respectively;P=0.076).CONCLUSION PS significantly improved the success rate of NKP in patients with difficult biliary cannulation.

关键词： Difficult biliary cannulation Endoscopic retrograde cholangiopancreatography Needle-knife papillotomy Pancreatic stent Selective biliary cannulation

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Creeping fat and gut microbiota in Crohn’s disease

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World Journal of gastroenterology 2025年第1期31卷 16-23页

作者： Ana EV Quaglio Daniéla O Magro Marcello Imbrizi Ellen CS De Oliveira Luiz C Di Stasi Ligia Y Sassaki Verum Ingredients Botucatu Technology ParkBotucatu 18605-525São PauloBrazil department of surgery Faculty of Medical SciencesState University of CampinasCampinas 13083-970São PauloBrazil department of gastroenterology Faculty of Medical SciencesUniversity of CampinasCampinas 13083-970São PauloBrazil department of Internal Medicine Medical SchoolSão Paulo State UniversityBotucatu 18618-686São PauloBrazil department of Biophysics and Pharmacology Institute of BiosciencesSão Paulo State UniversityBotucatu 18618-689São PauloBrazil

In this article,we explored the role of adipose tissue,especially mesenteric adipose tissue and creeping fat,and its association with the gut microbiota in the pathophysiology and progression of Crohn’s disease(CD).CD is a form of inflammatory bowel disease characterized by chronic inflammation of the gastrointestinal tract,influenced by genetic predisposition,gut microbiota dysbiosis,and environmental *** microbiota plays a crucial role in modulating immune response and intestinal inflammation and is associated with the onset and progression of ***,visceral adipose tissue,particularly creeping fat,a mesenteric adipose tissue characterized by hypertrophy and fibrosis,has been implicated in CD pathogenesis,inflammation,and *** bacteria from the gut microbiota may translocate into mesenteric adipose tissue,contributing to the formation of creeping fat and influencing CD *** creeping fat may be a protective barrier against bacterial invasion,its expansion can damage adjacent tissues,leading to *** gut microbiota through interventions such as fecal microbiota transplantation,probiotics,and prebiotics has shown potential in managing ***,more research is needed to clarify the mechanisms linking gut dysbiosis,creeping fat,and CD progression and develop targeted therapies for microbiota modulation and fat-related complications in patients with CD.

关键词： Creeping fat Mesenteric adipose tissue Gut microbiota Crohn’s disease Inflammatory bowel disease

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Liver parasites:A global endemic and journey from infestation to intervention

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World Journal of gastroenterology 2025年第1期31卷 8-15页

作者： Yumna Shahid Bushra Emman Shahab Abid department of Medicine Section of GastroenterologyAga Khan University HospitalKarachi 75500SindhPakistan Aga Khan Medical College Aga Khan University HospitalKarachi 75500SindhPakistan

Parasites have coexisted with humans throughout history,forming either symbiotic relationships or causing significant morbidity and *** liver is particularly vulnerable to parasitic infections,which can reside in,pass through,or be transported to the liver,leading to severe *** editorial explores various parasites that infect the liver,their clinical implications,and diagnostic considerations,as discussed in the article“Parasites of the liver:A global problem?”.Parasites reach the liver primarily through oral ingestion,mucosal penetration,or the bloodstream,with some larvae even penetrating the *** parasites such as cestodes(Echinococcus),trematodes(Clonorchis,Opisthorchis),nematodes(Ascaris),and protozoa(Entamoeba histolytica)can also cause systemic infections like visceral leishmaniasis,malaria,cryptosporidiosis,and *** infections like clonorchiasis and opisthorchiasis are linked to persistent hepatobiliary inflammation,potentially progressing to cholangiocarcinoma,a fatal bile duct cancer,particularly prevalent in Southeast *** global nature of liver parasite infestations is alarming,with hundreds of millions affected ***,control over treatment quality remains *** the significant public health threat posed by these parasites,international medical organizations must prioritize improved diagnosis,treatment,and preventive *** educational efforts and enhancing healthcare provider training are critical steps toward mitigating the global impact of parasitic liver diseases.

关键词： Liver flukes Nematodes Cestodes Trematodes Protozoa Parasites

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