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Diagnostic and therapeutic role of endoscopic ultrasound in liver diseases:A systematic review and meta-analysis

World Journal of Gastroenterology 2024年第7期30卷 742-758页

作者： Eyad Gadour Abeer Awad Zeinab Hassan Khalid Jebril Shrwani Bogdan Miutescu Hussein Hassan Okasha department of Gastroenterology and Hepatology King Abdulaziz Hospital-National GuardAhsa 31982Saudi Arabia department of internal medicine Faculty of MedicineZamzam University CollegeKhartoum 11113Sudan department of hepatogastroenterology Kasar Alainy HospitalFaculty of MedicineCairo UniversityCairo 11451Egypt department of internal medicine Stockport Hospitals NHS Foundation TrustManchester SK27JEUnited Kingdom Public Health Authority Saudi Center for Disease Prevention and ControlJazan 45142Saudi Arabia department of Clinical Infection Microbiology and ImmunologyInstitute of Infection and Global HealthSchool of Medicine and Life SciencesUniversity of LiverpoolLiverpoolUnited Kingdom department of Gastroenterology and Hepatology Victor Babes University of Medicine and PharmacyTimisoara 300041Romania Advanced Regional Research Center in Gastroenterology and Hepatology Victor Babes University of Medicine and PharmacyTimisoara 30041Romania department of internal medicine Division of Gastroenterology and HepatologyKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt

BACKGROUND In hepatology,the clinical use of endoscopic ultrasound(EUS)has experienced a notable increase in recent *** applications range from the diagnosis to the treatment of various liver ***,this systematic review summarizes the evidence for the diagnostic and therapeutic roles of EUS in liver *** To examine and summarize the current available evidence of the possible roles of the EUS in making a suitable diagnosis in liver diseases as well as the therapeutic accuracy and *** PubMed,Medline,Cochrane Library,Web of Science,and Google Scholar databases were extensively searched until October *** methodological quality of the eligible articles was assessed using the Newcastle-Ottawa scale or Cochrane Risk of Bias *** addition,statistical analyses were performed using the Comprehensive Meta-Analysis *** Overall,45 articles on EUS were included(28 on diagnostic role and 17 on therapeutic role).Pooled analysis demonstrated that EUS diagnostic tests had an accuracy of 92.4%for focal liver lesions(FLL)and 96.6%for parenchymal liver ***-guided liver biopsies with either fine needle aspiration or fine needle biopsy had low complication rates when sampling FLL and parenchymal liver diseases(3.1%and 8.7%,respectively).Analysis of data from four studies showed that EUS-guided liver abscess had high clinical(90.7%)and technical success(90.7%)without significant ***,EUS-guided interventions for the treatment of gastric varices(GV)have high technical success(98%)and GV obliteration rate(84%)with few complications(15%)and rebleeding events(17%).CONCLUSION EUS in liver diseases is a promising technique with the potential to be considered a first-line therapeutic and diagnostic option in selected cases.

关键词： Focal liver lesion Liver abscess drainage Fine needle aspiration Gastric varices Endoscopic ultrasound

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Des-gamma-carboxy prothrombin and alpha-fetoprotein levels as biomarkers for hepatocellular carcinoma and their correlation with radiological characteristics

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World Journal of Gastrointestinal Pathophysiology 2024年第1期15卷 37-43页

作者： Muhammad Ali Qadeer Zaigham Abbas Shaima Amjad Bushra Shahid Abeer Altaf Mehreen Siyal department of hepatogastroenterology Dr.Ziauddin University Hospital CliftonKarachi 75600Pakistan medicine Dr.Ziauddin University Hospital CliftonKarachi 75600Pakistan internal medicine Dr.Ziauddin University Hospital CliftonKarachi 75600Pakistan

BACKGROUND Alpha-fetoprotein(AFP),a commonly used biomarker for hepatocellular carcinoma(HCC),is normal in up to one-third of *** To evaluate the diagnostic performance of des-gamma-carboxy-prothrombin(DCP)alone and in combination with *** In this study,202 patients with radiologically proven HCC were enrolled,and their DCP and AFP levels were evaluated for their diagnostic *** The mean age of the enrolled patients was 58.5 years;72.0%were *** was elevated in 86.6%(n=175)of all patients,100.0%(n=74)of patients with portal vein thrombus,and 87.4%(n=111)of patients with multicentric *** was elevated in 64.3%(n=130)of all the patients,74%(n=55)of the patients with portal vein thrombus,and 71.6%(n=91)of the patients with multicentric HCC(P=0.030,0.001,and 0.015,respectively).In tumors less than 2 cm in size(n=46),DCP was increased in 32(69.5%)patients,and AFP was increased in 25(54.3%)patients(P=0.801).There was good pairing between DCP and AFP for HCCs of 2 cm size or larger(P2 cm was 0.74 for DCP and 0.59 for AFP;combining both markers resulted in an AUROC of *** tumors<2 cm,the AUROC was 0.25 for DCP and 0.40 for *** DCP,as an individual marker,had a better diagnostic performance in many cases of ***,DCP may replace AFP as the primary HCC biomarker.

关键词： Des-gamma-carboxy prothrombin Protein induced by vitamin K absence-II Cirrhosis Alpha-fetoprotein Biomarkers Hepatocellular carcinoma Portal vein thrombus

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Relationship between serum b2-microglobulin levels and virological breakthrough in HBeAg-negative chronic hepatitis B patients,under long-term treatment schedules including lamivudine

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World Journal of Gastroenterology 2005年第13期11卷 1922-1928页

作者： Ioannis S.Elefsiniotis Antonios Moulakakis Konstantinos D.Pantazis Irene Glynou Ioannis Ketikoglou Elena Vezali Helen Kada Epameinondas Tsianos department of internal medicine department of Microbiology department of hepatogastroenterology

AIM: Predictive value of serum b2-microglobulin (b2m)levels for virological breakthrough (VB) in HBeAg-negative chronic hepatitis B (CHB) patients under long-term treatment schedules including lamivudine (LAM).METHODS: Serum b2m levels were calculated during treatment in 25 CHB patients under long-term LAM monotherapy (group A) and 12 patients under initial interferon plus LAM treatment followed by LAM monotherapy (group B), using the MEIA technology. We used Cox proportional hazard models in order to investigate the association between serum b2m levels and ***: Seven of 25 patients (28%), 9/25 (36%) and 14/25 (56%) from group A and 0/12, 2/12 (16.6%) and 3/12 (25%) from group B exhibited VB at months 12, 24 and 36 of treatment, respectively. All patients, from both groups, who did not show VB exhibited b2m elevation in mo 3. The duration of b2m elevation was significantly longer in the virological responder's subgroup from group A than the non-responder's one (7.3±2.6 vs 3.8±3.4 mo,P = 0.02). In comparison to group A patients whose b2m levels were increased at 3 mo, patients whose b2m levels were decreased had 4.6 times higher risk of experiencing VB (RR = 4.6, P = 0.024). When baseline variables were simultaneously included in the same Cox model, decreased b2m status was still associated with increased risk of VB (RR = 12.2, P = 0.03).CONCLUSION: In HBeAg-negative CHB patients under either long-term LAM monotherapy or initial combination treatment, serum b2m levels at 3 mo of treatment,compared to baseline ones, might be a predictor of risk for VB.

关键词： Chronic hepatitis B Lamivudine Interferon Virological breakthrough B2-microglobulin

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Predictors of rebleeding after initial hemostasis with epinephrine injection in high-risk ulcers

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World Journal of Gastroenterology 2010年第43期16卷 5490-5495页

作者： Ming-Luen Hu King-Wah Chiu Yi-Chun Chiu Yeh-Pin Chou Tsung-Hui Hu Shue-Shian Chiou Seng-Kee Chuah Division of hepatogastroenterology Department of Internal Medicine Chang Gung Memorial Hospital-Kaohsiung Medical Center Chang Gung University College of Medicine

AIM: To identify the predictors of rebleeding after initial hemostasis with epinephrine injection (EI) in patients with high-risk ulcers. METHODS: Recent studies have revealed that endoscopic thermocoagulation, or clips alone or combined with EI are superior to EI alone to arrest ulcer bleeding. However, the reality is that EI monotherapy is still common in clinical practice. From October 2006 to April 2008, high-risk ulcer patients in whom hemorrhage was stopped after EI monotherapy were studied using clinical, laboratory and endoscopic variables. The patients were divided into 2 groups: sustained hemostasis and rebleeding. RESULTS: A total of 175 patients (144, sustainedhemostasis; 31, rebleeding) were enrolled. Univariate analysis revealed that older age (≥ 60 years), advanced American Society of Anesthesiology (ASA) status (category Ⅲ , Ⅳ and Ⅴ ), shock, severe anemia (hemoglobin < 80 g/L), EI dose ≥ 12 mL and severe bleeding signs (SBS) including hematemesis or hematochezia were the factors which predicted rebleeding. However, only older age, severe anemia, high EI dose and SBS were independent predictors. Among 31 rebleeding patients, 10 (32.2%) underwent surgical hemostasis, 15 (48.4%) suffered from delayed hemostasis causing major complications and 13 (41.9%) died of these complications. CONCLUSION: Endoscopic EI monotherapy in patients with high-risk ulcers should be avoided. Initial hemostasis with thermocoagulation, clips or additional hemostasis after EI is mandatory for such patients to ensure better hemostatic status and to prevent subsequent rebleeding, surgery, morbidity and mortality.

关键词： Epinephrine injection High-risk ulcers Initial hemostasis Predictors Rebleeding

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Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection

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World Journal of Gastroenterology 2010年第18期16卷 2265-2271页

作者： Chao-Hung Hung Jing-Houng Wang Tsung-Hui Hu Chien-Hung Chen Kuo-Chin Chang Yi-Hao Yen YuanHung Kuo Ming-Chao Tsai Chuan-Mo Lee Division of hepatogastroenterology Department of Internal MedicineChang Gung Memorial Hospital-Kaohsiung Medical CenterChang Gung University College of Medicine

AIM:To elucidate the role of insulin resistance(IR) and serum adiponectin level in hepatocellular carcinoma(HCC) associated with chronic hepatitis ***:Clinical and biochemical characteristics were collected from 165 consecutive patients with newly diagnosed *** model assessment of IR(HOMA-IR) and serum adiponectin level were investigated in 188 patients with different stages of hepatitis C virus(HCV) ***:Among HCC patients,type 2 diabetics(DM) was more prevalent in HCV subjects(35.6%,n = 59) compared to hepatitis B virus(HBV;12.7%,n = 63) or non-HBV,non-HCV cases(7.1%,n = 28).In patients with chronic hepatitis C,HCC subjects had higher blood sugar(P < 0.001),insulin level(P = 0.003) and HOMAIR(P = 0.018) than those with chronic hepatitis and advanced ***,male sex and body mass index were significantly associated with serum adiponectin level,whereas HOMA-IR was *** on stepwise logistic regression analysis,age(OR:1.124,P < 0.001),serum insulin level(OR:1.585,P < 0.001),HOMA-IR(OR:0.495,P = 0.001),DM(OR:11.601,P = 0.002) and male sex(OR:3.877,P = 0.016) were independently associated with *** result was similar even if the diabetic subjects were excluded for ***:Insulin resistance measured by HOMAIR,regardless of the presence of diabetes,is significantly associated with HCC development in patients with chronic HCV infection.

关键词： Hepatitis C virus Hepatocellular carcinoma Insulin resistance Diabetes Adiponectin

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Omeprazole maintenance therapy prevents recurrent ulcer bleeding after surgery for duodenal ulcer

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World Journal of Gastroenterology 2006年第5期12卷 791-795页

作者： Konstantinos Demertzis Dimitrios Polymeros Theodoros Emmanuel Konstantinos Triantafyllou Pericles Tassios Spiros D Ladas hepatogastroenterology Unit2~(nd) Department of Internal Medicine"Attikon"University General Hospital11528 AthensGreece

AIM： To evaluate the omeprazole maintenance therapy in patients with recurrent ulcer bleeding after surgery for duodenal ulcer. METHODS： We studied 15 consecutive patients with recurrent ulcer bleeding after surgery for duodenal ulcer. Omeprazole （20 mg/d） maintenance therapy was given after ulcer healing. In addition to clinical follow-up, ambulatory 24-h gastric pH assay was performed before and during omeprazole therapy in those patients and controls with previous duodenal ulcer surgery but no ulcer recurrence. RESULTS： All the 15 ulcers were healed after being treated with omeprazole （40 mg/d） for 2 too. Eleven patients with two （1-9） episodes of recurrent ulcer bleeding completed the follow-up （43, 12-72 too）. None of them had a bleeding episode while on omeprazole. One patient discontinued the therapy and had recurrent bleeding. The median 24-h fraction time of gastric pH 〈4 in patients was 80, 46-95%, and was reduced to 32, 13-70% by omeprazole （P= 0.002）. CONCLUSION： Long-term maintenance therapy with omeprazole （20 rag/day） is effective in preventing recurrent ulcer bleeding.

关键词： Duodenal ulcer Gastrectomy Vagotomy Omeprazole

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High Prevalence of Hepatitis B Virus Infection Compared to Human Immunodeficiency Virus among Blood Donors in Bangui

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Open Journal of Gastroenterology 2020年第6期10卷 137-143页

作者： Serges Magloire Camengo Police Bernard Bessanguem Eveline Mofini Benoît Elowa Georges Service Peggy Guéréndo Armelo Thibaut Yangba Kalebanga Nathalie Philomène Boua-Akélélo Tolmbaye Sem Fiacre Odilon Joseph Roger Molowa Kobendo department of hepatogastroenterology and internal medicine of “amitié sino-centrafraine” University Hospital Center Bangui Central African Republic department of internal medicine “Maman Elisabeth Domitien” University Hospital Center Bimbo Central African Republic department of Venerology Dermatology National University Hospital Center Bangui Central African Republic

Introduction: Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) infection is a public health problem worldwide, particularly in sub-Saharan Africa. Objective: to compare the epidemiological, clinical and biological characteristics of chronic HBV and HIV infection in blood donors at the National Center for Blood Transfusion (NCBT) in Bangui. Patients and Methods: This was an 8-month analytical cross-sectional study from August 10, 2011 to April 9, 2012. During this study, we consecutively enrolled consenting blood donors of both sexes in which the search for HBsAg and HIV infection was carried out. Results: During the study period, 850 blood donors were collected. HBsAg was found in 142 donors (16.7%), of whom 55 blood donors (6.5%) were coinfected with HIV. On the other hand, HIV serology was positive in 77 blood donors (9.1%) including 55 co-infected (6.5%) with HBV. In order to better compare the risk factors, we have not included HIV-HBV coinfected patients. Only 795 blood donors were selected for the risk factor study. There were 87 cases of HBsAg positive (10.9%) and 22 cases of HIV positive (2.8%). The average age of HIV and HBV infected patients was 25.7 and 26.2 years

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National guidelines for the diagnosis and treatment of hilar cholangiocarcinoma

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World Journal of Gastroenterology 2024年第9期30卷 1018-1042页

作者： Faisal Saud Dar Zaigham Abbas Irfan Ahmed Muhammad Atique Usman Iqbal Aujla Muhammad Azeemuddin Zeba Aziz Abu Bakar Hafeez Bhatti Tariq Ali Bangash Amna Subhan Butt Osama Tariq Butt Abdul Wahab Dogar Javed Iqbal Farooqi Faisal Hanif Jahanzaib Haider Siraj Haider Syed Mujahid Hassan Adnan Abdul Jabbar Aman Nawaz Khan Muhammad Shoaib Khan Muhammad Yasir Khan Amer Latif Nasir Hassan Luck Ahmad Karim Malik Kamran Rashid Sohail Rashid Mohammad Salih Abdullah Saeed Amjad Salamat Ghias-un-Nabi Tayyab Aasim Yusuf Haseeb Haider Zia Ammara Naveed department of Hepatopancreatic Biliary Surgery&Liver Transplant Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan department of hepatogastroenterology and Liver Transplantation Dr.Ziauddin University HospitalKarachi 75600SindhPakistan University of Aberdeen Aberdeen B243FXUnited Kingdom department of Pathology Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan department of Gastroenterology&Hepatology Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan department of Radiology Aga Khan UniversityKarachi 74800Pakistan department of Oncology Hameed Latif HospitalLahore 54000Pakistan Division of Hepatopancreatic Biliary Surgery&Liver Transplantation Shifa International HospitalIslamabad 44000Pakistan department of Hepatopancreatic Biliary Surgery&Liver Transplant Shaikh Zayed Hospital and Post Graduate Medical InstituteLahore 54000Pakistan department of medicine Aga Khan University HospitalKarachi 74800Pakistan department of Liver Transplant Pir Abdul Qadir Shah Jeelani Institute of Medical SciencesGambat 66020Pakistan department of medicine&Gastroenterology Lifecare Hospital and Research CentrePeshawar 25000Khyber PakhtunkhwaPakistan department of Hepatopancreatobiliary&Liver Transplant Bahria International HospitalLahore 54000Pakistan department of Surgery Hepatopancreatobiliary&Liver TransplantDow University of Health SciencesKarachi 74800Pakistan department of Gastroenterology Hepatology&NutritionPir Abdul Qadir Shah Jeelani Institute of Medical SciencesGambat 66020Pakistan department of Oncology Dr.Ziauddin HospitalKarachi 74800Pakistan department of Radiology Rehman Medical InstitutePeshawar 25000Pakistan Army Liver Transplant Unit Pak Emirates Military HospitalRawalpindi 46000Pakistan department of Gastroenterology Sindh Institute of Urology and TransplantationKarachi 75500Pakistan Rashid Nursing Home and Cancer Clinic Rashid Nursing Home and Cancer ClinicRawalpindi 46000Pakistan department of Gastroentero

A consensus meeting of national experts from all major national hepatobiliary centres in the country was held on May 26,2023,at the Pakistan Kidney and Liver Institute&Research Centre(PKLI&RC)after initial consultations with the *** Pakistan Society for the Study of Liver Diseases(PSSLD)and PKLI&RC jointly organised this *** effort was based on a comprehensive literature review to establish national practice guidelines for hilar cholangiocarcinoma(hCCA).The consensus was that hCCA is a complex disease and requires a multidisciplinary team approach to best manage these *** coordinated effort can minimise delays and give patients a chance for curative treatment and effective *** diagnostic and staging workup includes high-quality computed tomography,magnetic resonance imaging,and magnetic resonance *** cytology or biopsy utilizing endoscopic retrograde cholangiopancreatography is a mainstay for ***,histopathologic confirmation is not always required before *** ultrasound with fine needle aspiration of regional lymph nodes and positron emission tomography scan are valuable adjuncts for *** only curative treatment is the surgical resection of the biliary tree based on the Bismuth-Corlette *** patients with unresectable hCCA can be considered for liver *** chemotherapy should be offered to patients with a high risk of *** use of preoperative biliary drainage and the need for portal vein embolisation should be based on local multidisciplinary *** with acute cholangitis can be drained with endoscopic or percutaneous biliary *** chemotherapy with cisplatin and gemcitabine has shown improved survival in patients with irresectable and recurrent hCCA.

关键词： Hilar cholangiocarcinoma Bismuth-Corlette classification Memorial Sloan Kettering Cancer Centre Staging Preoperative biliary drainage Portal vein embolisation Surgical resection Hepatectomy

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Gut microbiota and non-alcoholic fatty liver disease

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Hepatobiliary & Pancreatic Diseases International 2015年第6期14卷 572-581页

作者： Paraskevas Gkolfakis George Dimitriadis Konstantinos Triantafyllou hepatogastroenterology Unit Second Department of Internal Medicine and Research InstituteAttikon University General HospitalMedical SchoolAthens University

BACKGROUND： Non-alcoholic fatty liver disease （NAFLD） is a common disorder with poorly understood pathogenesis. Beyond environmental and genetic factors, cumulative data support the causative role of gut microbiota... 详细信息

关键词： non-alcoholic fatty liver disease non-alcoholic steatohepatitis gut microbiota 16S r RNA sequencing archaea

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Swab culture monitoring of automated endoscope reprocessors after high-level disinfection

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World Journal of Gastroenterology 2012年第14期18卷 1660-1663页

作者： Lung-Sheng Lu Yi-Chun Chiu Ming-Tzung Lin Tsung-Hui Hu King-Wah Chiu Division of hepatogastroenterology Department of Internal MedicineChang Gung Memorial Hospital-Kaohsiung Medical CenterChang Gung University College of Medicine

AIM:To conduct a bacterial culture study for monitoring decontamination of automated endoscope reprocessors(AERs) after high-level disinfection(HLD).METHODS:From February 2006 to January 2011,authors conducted randomized consecutive sampling each month for 7 *** collected a total of 420 swab cultures,including 300 cultures from 5 gastroscope AERs,and 120 cultures from 2 colonoscope *** cultures were obtained from the residual water from the AERs after a full reprocessing *** were cultured to test for aerobic bacteria,anaerobic bacteria,and mycobacterium ***:The positive culture rate of the AERs was 2.0%(6/300) for gastroscope AERs and 0.8%(1/120) for colonoscope *** the positive cultures,including 6 from gastroscope and 1 from colonoscope AERs,showed monofloral *** the gastroscopeAER samples,50%(3/6) were colonized by aerobic bacterial and 50%(3/6) by fungal ***:A full reprocessing cycle of an AER with HLD is adequate for disinfection of the *** culture is a useful method for monitoring AER decontamination after each reprocessing *** contamination of AERs after reprocessing should also be kept in mind.

关键词： Automated endoscope reprocessor Gastrointestinal scope High-level disinfection Swab culture Monitoring Decontamination

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