Pub Date : 2025-12-02DOI: 10.1016/j.gastrohep.2025.502633
Gonzalo Latorre, Alberto Espino, Raúl Araya, Matías Arteaga, Harold Benites-Goñi, María Ester Bufadel, Dacio Cabrera-Hinojosa, Roberto Candia, Julian Cordero, Oscar Corsi, Pablo Cortés, Felipe Donoso, Fabian Emura, Carolina Heredia, Daniel Martínez, Rodrigo Mansilla-Vivar, Leticia Moreira, Felipe Moscoso, María Blanca Piazuelo, Mauricio Pizarro, Diego Reyes, Arnoldo Riquelme, Shailja C Shah, Felipe Silva, Verónica Silva, Paulina Toledo, Antonio Rollán
Gastric cancer is one of the leading causes of cancer mortality in Chile. To optimize early detection and surveillance of gastric premalignant conditions, the Chilean Association of Digestive Endoscopy (ACHED), together with the Chilean Society of Gastroenterology, updated its 2014 clinical guideline. Using the AGREE II methodology, multidisciplinary working groups conducted systematic reviews in PubMed, Cochrane, and Scielo through December 2024. Recommendations were agreed upon via a Delphi panel (≥80% agreement) and graded according to GRADE, assessing evidence quality and recommendation strength. An expert panel of Chilean and international gastroenterology, endoscopy and pathology specialists reviewed the evidence and reached consensus to issue recommendations for opportunistic gastric cancer screening and surveillance using upper GI endoscopy in adults. These recommendations are feasible to implement in Chile and other Latin American countries with a high incidence of gastric cancer that have the necessary resources available. They complement any future efforts at population screening and aim to improve early detection and prognosis of gastric cancer in high-risk populations.
{"title":"Chilean Association of Digestive Endoscopy (ACHED) guidelines for the detection of early gastric cancer and surveillance of gastric premalignant conditions in high-risk populations.","authors":"Gonzalo Latorre, Alberto Espino, Raúl Araya, Matías Arteaga, Harold Benites-Goñi, María Ester Bufadel, Dacio Cabrera-Hinojosa, Roberto Candia, Julian Cordero, Oscar Corsi, Pablo Cortés, Felipe Donoso, Fabian Emura, Carolina Heredia, Daniel Martínez, Rodrigo Mansilla-Vivar, Leticia Moreira, Felipe Moscoso, María Blanca Piazuelo, Mauricio Pizarro, Diego Reyes, Arnoldo Riquelme, Shailja C Shah, Felipe Silva, Verónica Silva, Paulina Toledo, Antonio Rollán","doi":"10.1016/j.gastrohep.2025.502633","DOIUrl":"10.1016/j.gastrohep.2025.502633","url":null,"abstract":"<p><p>Gastric cancer is one of the leading causes of cancer mortality in Chile. To optimize early detection and surveillance of gastric premalignant conditions, the Chilean Association of Digestive Endoscopy (ACHED), together with the Chilean Society of Gastroenterology, updated its 2014 clinical guideline. Using the AGREE II methodology, multidisciplinary working groups conducted systematic reviews in PubMed, Cochrane, and Scielo through December 2024. Recommendations were agreed upon via a Delphi panel (≥80% agreement) and graded according to GRADE, assessing evidence quality and recommendation strength. An expert panel of Chilean and international gastroenterology, endoscopy and pathology specialists reviewed the evidence and reached consensus to issue recommendations for opportunistic gastric cancer screening and surveillance using upper GI endoscopy in adults. These recommendations are feasible to implement in Chile and other Latin American countries with a high incidence of gastric cancer that have the necessary resources available. They complement any future efforts at population screening and aim to improve early detection and prognosis of gastric cancer in high-risk populations.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502633"},"PeriodicalIF":1.9,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.gastrohep.2025.502472
Carles Iniesta-Navalón , Lorena Rentero-Redondo , Rosa Gómez-Espín , Manuel Ríos Saorín , Isabel Nicolás de Prado , Juan José Gascón-Cánovas
Background and aims
Inflammatory bowel disease (IBD) features diverse clinical presentations and progressions, impacting IFX exposure. Understanding IFX serum concentration changes is crucial for tailored monitoring in specific patient groups. The main objective of this study was to analyze ITL trajectories in patients with IBD to identify distinct groups and subgroups, revealing heterogeneity in treatment responses.
Methods
A retrospective cohort study was conducted involving IBD patients treated with infliximab in a regional reference hospital in Spain. Latent class linear mixed models were applied to identify subgroups based on serum infliximab measurements over time. To analyze the factors associated with IFX discontinuation, we employed both logistic regression and Cox regression models.
Results
The study included 165 IBD patients, and a total of 799 ITL samples were analyzed. The selected model included three clusters, with a random intercept and a random effect on both time and natural cubic spline time in the linear mixed model. Cluster 1 (20.6%) had lower IFX exposure, with 93.9% experiencing treatment discontinuation, compared to 45.1% in Cluster 2 (43.0%) and 43.3% in Cluster 3 (36.4%) (p < 0.001). Treatment discontinuation was observed in 91 individuals (55.2%) out of the total patients. In the multivariate analysis, the presence of cluster 1 was a significant predictor (OR: 7.25, 95% CI: 1.45–36.12). Bayesian dose adjustment was found to significantly reduce the risk of IFX discontinuation (OR: 0.19, 95% CI: 0.46–1.96).
Conclusions
The lack of TDM during induction and a lower proportion of adjustments made through Bayesian methods were associated with a subgroup demonstrating suboptimal pharmacokinetic profiles and reduced drug persistence. These findings highlight the clinical relevance of model-informed TDM in optimizing IFX exposure and minimizing treatment discontinuation in IBD.
{"title":"Exploring infliximab serum level variability in inflammatory bowel disease: Comprehensive analysis of patient subgroups and treatment outcomes","authors":"Carles Iniesta-Navalón , Lorena Rentero-Redondo , Rosa Gómez-Espín , Manuel Ríos Saorín , Isabel Nicolás de Prado , Juan José Gascón-Cánovas","doi":"10.1016/j.gastrohep.2025.502472","DOIUrl":"10.1016/j.gastrohep.2025.502472","url":null,"abstract":"<div><h3>Background and aims</h3><div>Inflammatory bowel disease (IBD) features diverse clinical presentations and progressions, impacting IFX exposure. Understanding IFX serum concentration changes is crucial for tailored monitoring in specific patient groups. The main objective of this study was to analyze ITL trajectories in patients with IBD to identify distinct groups and subgroups, revealing heterogeneity in treatment responses.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted involving IBD patients treated with infliximab in a regional reference hospital in Spain. Latent class linear mixed models were applied to identify subgroups based on serum infliximab measurements over time. To analyze the factors associated with IFX discontinuation, we employed both logistic regression and Cox regression models.</div></div><div><h3>Results</h3><div>The study included 165 IBD patients, and a total of 799 ITL samples were analyzed. The selected model included three clusters, with a random intercept and a random effect on both time and natural cubic spline time in the linear mixed model. Cluster 1 (20.6%) had lower IFX exposure, with 93.9% experiencing treatment discontinuation, compared to 45.1% in Cluster 2 (43.0%) and 43.3% in Cluster 3 (36.4%) (<em>p</em> <!--><<!--> <!-->0.001). Treatment discontinuation was observed in 91 individuals (55.2%) out of the total patients. In the multivariate analysis, the presence of cluster 1 was a significant predictor (OR: 7.25, 95% CI: 1.45–36.12). Bayesian dose adjustment was found to significantly reduce the risk of IFX discontinuation (OR: 0.19, 95% CI: 0.46–1.96).</div></div><div><h3>Conclusions</h3><div>The lack of TDM during induction and a lower proportion of adjustments made through Bayesian methods were associated with a subgroup demonstrating suboptimal pharmacokinetic profiles and reduced drug persistence. These findings highlight the clinical relevance of model-informed TDM in optimizing IFX exposure and minimizing treatment discontinuation in IBD.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 10","pages":"Article 502472"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.gastrohep.2025.502492
Paula Sirera-Sirera , Núria Lluís , Fèlix Lluís , Pedro Zapater , Pablo López-Guillén , José M. Ramia-Ángel , Rahma Amrani , Trinidad Castillo-García , José Andreu-Viseras , Karina Cárdenas-Jaén , Lucía Guilabert , Sara Pérez-Brotons , Emma Martínez-Moneo , Nerea Gendive-Martin , Iván González Hermoso , Enrique de-Madaria , María José Ferri
Objective
Exocrine pancreatic insufficiency (EPI) is common after pancreatic surgery. In patients with chronic pancreatitis, our previous results supported the use of fecal elastase-1 (FE-1) over the 13C-mixed triglyceride breath test (13C-MTBT) for the diagnosis of EPI. However, it is poorly established how the performance of these two tests compares to the diagnosis of EPI after pancreatic surgery.
Patients and methods
FE-1 and 13C-MTBT were compared with the gold standard coefficient of fat absorption (CFA). Area under ROC curve (AUC) and best cutoffs were used to assess presence of EPI. Patient characteristics were evaluated by extent of pancreatic resection.
Results
The AUC (95% confidence interval) was 0.724 (0.578–0.871) for FE-1 and 0.640 (0.482–0.799) for 13C-MTBT in the diagnosis of EPI. A pairwise comparison of the FE-1 and 13C-MTBT AUCs showed no statistically significant difference (P = .20). The best cut-off point was 65.5 μg/g for FE-1 and 22.5% for 13C-MTBT. According to contingency analysis, both the FE-1 threshold of 65.5 μg/g (P = .005) and the 13C-MTBT threshold of 22.5% (P = .015) showed statistical significance for diagnosing EPI.
Conclusion
FE-1 was more accurate for diagnosing EPI after pancreatic surgery, but the differences were not statistically different.
{"title":"Fecal elastase-1 and 13C-mixed triglyceride breath test vs. coefficient of fat absorption to diagnose exocrine pancreatic insufficiency after pancreatic surgery","authors":"Paula Sirera-Sirera , Núria Lluís , Fèlix Lluís , Pedro Zapater , Pablo López-Guillén , José M. Ramia-Ángel , Rahma Amrani , Trinidad Castillo-García , José Andreu-Viseras , Karina Cárdenas-Jaén , Lucía Guilabert , Sara Pérez-Brotons , Emma Martínez-Moneo , Nerea Gendive-Martin , Iván González Hermoso , Enrique de-Madaria , María José Ferri","doi":"10.1016/j.gastrohep.2025.502492","DOIUrl":"10.1016/j.gastrohep.2025.502492","url":null,"abstract":"<div><h3>Objective</h3><div><span>Exocrine pancreatic insufficiency (EPI) is common after pancreatic surgery. In patients with chronic pancreatitis, our previous results supported the use of fecal elastase-1 (FE-1) over the </span><sup>13</sup>C-mixed triglyceride breath test (<sup>13</sup><span>C-MTBT) for the diagnosis of EPI<span>. However, it is poorly established how the performance of these two tests compares to the diagnosis of EPI after pancreatic surgery.</span></span></div></div><div><h3>Patients and methods</h3><div>FE-1 and <sup>13</sup>C-MTBT were compared with the gold standard coefficient of fat absorption (CFA). Area under ROC curve (AUC) and best cutoffs were used to assess presence of EPI. Patient characteristics were evaluated by extent of pancreatic resection.</div></div><div><h3>Results</h3><div>The AUC (95% confidence interval) was 0.724 (0.578–0.871) for FE-1 and 0.640 (0.482–0.799) for <sup>13</sup>C-MTBT in the diagnosis of EPI. A pairwise comparison of the FE-1 and <sup>13</sup>C-MTBT AUCs showed no statistically significant difference (<em>P</em> <!-->=<!--> <!-->.20). The best cut-off point was 65.5<!--> <!-->μg/g for FE-1 and 22.5% for <sup>13</sup>C-MTBT. According to contingency analysis, both the FE-1 threshold of 65.5<!--> <!-->μg/g (<em>P</em> <!-->=<!--> <!-->.005) and the <sup>13</sup>C-MTBT threshold of 22.5% (<em>P</em> <!-->=<!--> <!-->.015) showed statistical significance for diagnosing EPI.</div></div><div><h3>Conclusion</h3><div>FE-1 was more accurate for diagnosing EPI after pancreatic surgery, but the differences were not statistically different.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 10","pages":"Article 502492"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The use of herbal products and dietary supplements (HDS) carries a potential risk of liver toxicity. Data on HDS consumption among patients attending liver disease clinics remain unexplored.
Objective
To determine the frequency, types and reasons for HDS consumption in patients attending a specialized liver disease outpatient clinic.
Methods
Prospective study including consecutive patients attending the hepatology outpatient clinic at the Hospital Clínic of Barcelona from June 2023 to October 2023. Following a standard medical visit, a trained nurse conducted a structured interview to assess HDS consumption.
Results
A total of 150 patients were included, with a median age of 59 (IQR: 49–67) and male predominance (56%, n = 84). Only 12 patients (8%) reported HDS consumption during a standard medical interview, while the number increased to 92 (61%) after nurse-led structured interview. The primary reasons for dietary supplements use included vitamin supplementation (43%), fitness improvement (10.5%) and hair/nail health (10.5%). For herbal products, the most common reason for use was pleasure (73%). Reported HDS products with potential hepatotoxicity (levels A and B) were green tea (n = 16), turmeric with black pepper (n = 11), aloe (n = 2), greater celandine (n = 1) and black cohosh (n = 1).
Conclusion
HDS use is highly prevalent among patients with liver disease, but a structured interview is crucial to detect their consumption, as they usually forget spontaneous reporting. Importantly, a significant proportion of these products carry a risk of hepatic toxicity, underscoring the need for increased patient education and clinical vigilance.
{"title":"Unveiling the hidden risk: Herbal and dietary supplement consumption in liver disease patients","authors":"Elia Canga , Anna Pocurull , Montserrat Rodriguez-Reyes , Cristina Collazos , Laura Martín , Zoe Mariño , Sabela Lens , Xavier Forns","doi":"10.1016/j.gastrohep.2025.502520","DOIUrl":"10.1016/j.gastrohep.2025.502520","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of herbal products and dietary supplements (HDS) carries a potential risk of liver toxicity. Data on HDS consumption among patients attending liver disease clinics remain unexplored.</div></div><div><h3>Objective</h3><div>To determine the frequency, types and reasons for HDS consumption in patients attending a specialized liver disease outpatient clinic.</div></div><div><h3>Methods</h3><div>Prospective study including consecutive patients attending the hepatology outpatient clinic at the Hospital Clínic of Barcelona from June 2023 to October 2023. Following a standard medical visit, a trained nurse conducted a structured interview to assess HDS consumption.</div></div><div><h3>Results</h3><div>A total of 150 patients were included, with a median age of 59 (IQR: 49–67) and male predominance (56%, <em>n</em> <!-->=<!--> <!-->84). Only 12 patients (8%) reported HDS consumption during a standard medical interview, while the number increased to 92 (61%) after nurse-led structured interview. The primary reasons for dietary supplements use included vitamin supplementation (43%), fitness improvement (10.5%) and hair/nail health (10.5%). For herbal products, the most common reason for use was pleasure (73%). Reported HDS products with potential hepatotoxicity (levels A and B) were green tea (<em>n</em> <!-->=<!--> <!-->16), turmeric with black pepper (<em>n</em> <!-->=<!--> <!-->11), aloe (<em>n</em> <!-->=<!--> <!-->2), greater celandine (<em>n</em> <!-->=<!--> <!-->1) and black cohosh (<em>n</em> <!-->=<!--> <!-->1).</div></div><div><h3>Conclusion</h3><div>HDS use is highly prevalent among patients with liver disease, but a structured interview is crucial to detect their consumption, as they usually forget spontaneous reporting. Importantly, a significant proportion of these products carry a risk of hepatic toxicity, underscoring the need for increased patient education and clinical vigilance.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 10","pages":"Article 502520"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.gastrohep.2025.502495
Manuel González Bermúdez , María Lourdes García Jiménez , Sergio Rodríguez Rojo , Jose Antonio Romero González , Pablo Concheiro Coello , Javier Aguirrezabalaga González , José Francisco Noguera Aguilar
Objective
To estimate the incidence of complications following ileostomy reversal and to identify associated risk factors.
Patients and methods
A retrospective cohort study was conducted, including patients who underwent rectal cancer surgery with a protective ileostomy. The minimum follow-up period was one year. A univariate analysis was performed to identify potential risk factors for complications, and variables with P<0.1 were included in a multivariate analysis.
Results
Between January 1, 2015, and December 31, 2023, a total of 220 patients underwent surgery. Thirteen percent did not undergo ileostomy reversal. Thus, 193 patients were included in the final analysis. The median time to ileostomy reversal was 292 days. Postoperative complications occurred in approximately 27.5% of cases. Among the potential risk factors, albumin levels < 4 g/dl, open surgical approach for rectal pathology, absence of efferent loop stimulation, and side-to-side anastomosis were associated with P<.1 in univariate analysis. In the multivariate analysis, only low albumin levels and the open surgical approach for rectal pathology remained significantly associated with an increased risk of complications.
Conclusion
Modifiable factors such as the use of a laparoscopic approach for rectal surgery, stimulation of the efferent loop, and optimization of preoperative nutritional status may help reduce the incidence of postoperative complications.
{"title":"Análisis de los factores de riesgo de complicación tras la reconstrucción de ileostomía de protección en los pacientes intervenidos por cáncer rectal","authors":"Manuel González Bermúdez , María Lourdes García Jiménez , Sergio Rodríguez Rojo , Jose Antonio Romero González , Pablo Concheiro Coello , Javier Aguirrezabalaga González , José Francisco Noguera Aguilar","doi":"10.1016/j.gastrohep.2025.502495","DOIUrl":"10.1016/j.gastrohep.2025.502495","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the incidence of complications following ileostomy reversal and to identify associated risk factors.</div></div><div><h3>Patients and methods</h3><div>A retrospective cohort study was conducted, including patients who underwent rectal cancer surgery with a protective ileostomy. The minimum follow-up period was one year. A univariate analysis was performed to identify potential risk factors for complications, and variables with <em>P</em><0.1 were included in a multivariate analysis.</div></div><div><h3>Results</h3><div>Between January 1, 2015, and December 31, 2023, a total of 220 patients underwent surgery. Thirteen percent did not undergo ileostomy reversal. Thus, 193 patients were included in the final analysis. The median time to ileostomy reversal was 292 days. Postoperative complications occurred in approximately 27.5% of cases. Among the potential risk factors, albumin levels <<!--> <!-->4<!--> <!-->g/dl, open surgical approach for rectal pathology, absence of efferent loop stimulation, and side-to-side anastomosis were associated with <em>P</em><.1 in univariate analysis. In the multivariate analysis, only low albumin levels and the open surgical approach for rectal pathology remained significantly associated with an increased risk of complications.</div></div><div><h3>Conclusion</h3><div>Modifiable factors such as the use of a laparoscopic approach for rectal surgery, stimulation of the efferent loop, and optimization of preoperative nutritional status may help reduce the incidence of postoperative complications.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 10","pages":"Article 502495"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.gastrohep.2025.502469
Alejandro García Martínez, María Regla Gallego Gallegos
{"title":"Empleo de ustekinumab como tratamiento de elección en paciente con colitis inmunomediada corticodependiente y secundaria a pembrolizumab","authors":"Alejandro García Martínez, María Regla Gallego Gallegos","doi":"10.1016/j.gastrohep.2025.502469","DOIUrl":"10.1016/j.gastrohep.2025.502469","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 10","pages":"Article 502469"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.gastrohep.2025.502447
Miriam Bragado Pascual, Rosanna Villanueva Hernández, M. Pilar Delgado Alvarez, Luis Ricardo Gotuzzo Altez, Juan Manuel Blanco Esteban
{"title":"Spontaneous cholecysto-cutaneous fistula in a patient with peritoneal carcinomatosis","authors":"Miriam Bragado Pascual, Rosanna Villanueva Hernández, M. Pilar Delgado Alvarez, Luis Ricardo Gotuzzo Altez, Juan Manuel Blanco Esteban","doi":"10.1016/j.gastrohep.2025.502447","DOIUrl":"10.1016/j.gastrohep.2025.502447","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 10","pages":"Article 502447"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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