Arab Journal of Gastroenterology最新文献

{"title":"PIMREG modulation of PI3K/Akt pathway enhances sorafenib resistance in Huh7 cells","authors":"Lei Zhang ,&nbsp;Aijun Gao ,&nbsp;Kaiyun Peng","doi":"10.1016/j.ajg.2025.05.002","DOIUrl":"10.1016/j.ajg.2025.05.002","url":null,"abstract":"<div><h3>Background and study aims</h3><div>Sorafenib, as a novel multi-targeted oral tumor chemotherapeutic drug, has been found to exert an impact on the inhibition of cancer growth. Phosphatidylinositol-binding reticulin assembly protein interacting with mitotic regulatory factors (PIMREG) is strongly associated with oncology to drug resistance. However, how PIMREG modulates therapy tolerance to sorafenib in HCC and its potential regulatory mechanisms remain unclear. This study is abouta mechanistic approach to examine the action and mechanism of PIMREG in HCC-mediated sorafenib resistance.</div></div><div><h3>Material and methods</h3><div>The human hepatocellular carcinoma sensitive cell line Huh7 and drug-resistant cell line Huh7/SFB were used for the study, and different rates of PIMREG expansion in both cells were detected. Next, the study transfected PIMREG overexpression and interference vector into hepatoma cell line Huh7/SFB, and acted on the cells with solafenib exhibiting a concentration gradient. The growth inhibition rate and IC50 value of cells were detected by MTT method to determine the concentration and time of drug addition. Then, this study employed MTT, qRT-PCR, flow cytometry, and Western blot to assay the growth of these cells, which were induced through overexpression and disruption of PIMREG, in combination with sorafenib. The study also constructed an in vivo mouse tire sample test in order to investigate the influence of PIMREG upon the in vitro efficacy of sorafenib. In addition, the study used LY294002 inhibitors to explore the molecular mechanisms of PIMREG-mediated resistance to sorafenib in Huh7/SFB cells.</div></div><div><h3>Results</h3><div>The expression level of PIMREG in cells of the Huh7/SFB resistant strain was clearly higher than that in cells of the sensitive strain Huh7. After transfection of sh-PIMREG, the IC50 value decreased significantly, while OE-PIMREG significantly increased the IC50 value of sorafinib. Compared with the control group, inhibition of cell proliferation by sorafenib was enhanced after interference with PIMREG, while the effect of overexpression of PIMREG was on the contrary. The efficacy of sorafenib was enhanced by knockout of PIMREG in living organisms. In addition, the PI3K/AKT signal pathway was necessary for PIMREG-induced sorafenib resistance. Subsequently, PIMREG regulated sorafenib-induced inhibition of the PI3K/AKT signaling pathway, and LY294002 blocked the signal pathway to reduce PIMREG-induced resistance.</div></div><div><h3>Conclusion</h3><div>All in all, an increase in HCC resistance to sorafenib via the PIMREG-mediated PI3K/AKT pathway suggests that PIMREG is a key tumor-associated gene with significant implications for sorafenib resistance in tumor cells.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"26 3","pages":"Pages 241-249"},"PeriodicalIF":1.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530530","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}

{"title":"Efficacy of latiglutenase in treating celiac disease: a systematic review and meta-analysis of randomized controlled trials","authors":"Asmaa M. Albasha Hejazi ,&nbsp;Mohamed Abd–ElGawad ,&nbsp;Ahmed Farid Gadelmawla ,&nbsp;Amany Abd-Elhafeez ,&nbsp;Heba Mahmoud Abdelraheem ,&nbsp;Ekram Hasanin ,&nbsp;Majd Kahaleh ,&nbsp;Bayan Alnaser ,&nbsp;Nazir Ibrahim","doi":"10.1016/j.ajg.2025.05.001","DOIUrl":"10.1016/j.ajg.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Celiac Disease (CeD) is a chronic immunological illness. So far, the only known treatment for CeD is a lifelong gluten-free diet. However, enzyme therapy was proposed as an alternative. This study aimed to assess the impact of Latiglutenase, an example of enzyme therapy, on CeD patients compared to a placebo through a comprehensive assessment of existing literature.</div></div><div><h3>Methods</h3><div>We searched the following databases: Scopus, Web of Science, Cochrane Central Library, and PubMed from their respective inception date to February 18, 2024. We included randomized controlled trials comparing Latiglutenase with a placebo, with accessible full text in English. Outcomes included symptoms and histological findings improvement. We used the Revman 5.4 software to conduct the statistical analysis. For assessing the risk of bias, we utilized the Cochrane Collaboration tool ROB 2.</div></div><div><h3>Results</h3><div>Data from five randomized controlled trials was collected, with 1003 participants meeting the inclusion criteria. We found no significant differences between the Latiglutenase group and placebo group regarding adverse events like bloating (P = 0.55), nausea (P = 0.43), vomiting (P = 0.39), diarrhea (P = 0.83), tiredness (P = 0.83), headache (P = 0.08), and flatulence (P = 0.64); and histological findings like villous height to crypt depth ratio (Vh:Cd ratio), and intraepithelial lymphocytes (IELs) (mean difference (MD) = 0.19, 95 % confidence interval (CI) = [−0.24,0.62]; P = 0.39 and MD = −10.78, 95 % CI = [−26.97, 5.40]; P = 0.19, respectively).</div></div><div><h3>Conclusion</h3><div>Latiglutenase did not significantly improve adverse events or histological findings in CeD patients. However, there is still a need for further RCTs to evaluate its effectiveness more precisely.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"26 3","pages":"Pages 225-233"},"PeriodicalIF":1.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530457","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}

{"title":"Epidemiology and drug resistance of Salmonella and Aeromonas in the faecal samples from pediatric patients with infectious diarrhea at a children’s medical center in Suzhou, China from 2016 to 2023","authors":"Yuanyuan Gao ,&nbsp;Hanyue Yang ,&nbsp;Zidan Liu ,&nbsp;Yunzhong Wang ,&nbsp;Xin Zhang ,&nbsp;Yang Li","doi":"10.1016/j.ajg.2025.04.003","DOIUrl":"10.1016/j.ajg.2025.04.003","url":null,"abstract":"<div><h3>Background and study aims</h3><div>Diarrheal diseases among children represent a prominent global health challenge, leading to significant morbidity and mortality, especially in emerging economies. This study aims to investigate the prevalence and trends of bacterial pathogens causing diarrhea in children.</div></div><div><h3>Patients and methods</h3><div>We retrospectively conducted an analysis of outpatient and inpatient records at Children’s Hospital of Soochow University, from 2016 to 2023. Only children presenting with diarrhea were included in the study. The clinical microbiology laboratory performed cultivation and identification of faecal samples, along with drug susceptibility testing on isolated <em>Salmonella</em> and <em>Aeromonas</em> species.</div></div><div><h3>Results</h3><div>A total of 2,163 cases of <em>Salmonella</em>, 334 cases of <em>Aeromonas</em> were identified from 13,662 faecal culture samples. There was a noticeable annual increase in the detection of <em>Salmonella</em> and <em>Aeromonas</em> in recent years. Samples from children with the age group of 12 to 35 months were more likely to be positive for <em>Salmonella</em> than those from children with other age groups, whereas those with the age group of 6 to 11 months were more prone to <em>Aeromonas</em>. Samples taken in the summer were most likely to be positive for <em>Salmonella</em> and <em>Aeromonas</em>. Samples from hospitalized children were considerably more likely to be positive for <em>Salmonella</em> than those from outpatient children. <em>Salmonella</em>-infected children were predominantly admitted to departments of digestion and infectious diseases, whereas <em>Aeromonas</em>-infected patients were spread across various clinics, especially gastroenterology. <em>Salmonella</em> Group B and <em>Aeromonas punctata (caviae)</em> were the most prevalent strains among their respective species. Notably, the resistance of <em>Salmonella</em> and <em>Aeromonas</em> to fluoroquinolone antibiotics has been escalating since 2018, with inpatients exhibiting a significantly higher rate of drug resistance compared to outpatients.</div></div><div><h3>Conclusion</h3><div>The integration of bacterial identification and drug susceptibility testing is crucial for the effective prevention and management of childhood diarrhea. The use of targeted antibiotics is essential to curb the rise of drug-resistant strains and ensure effective treatment outcomes.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"26 3","pages":"Pages 254-261"},"PeriodicalIF":1.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530459","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}

{"title":"Expansively splenic reflective foci: A case-based résumé","authors":"Omkolsoum Alhaddad ,&nbsp;Maha Elsabaawy ,&nbsp;Mohamed Eissa ,&nbsp;Rasha Abdelhafeez ,&nbsp;Eman Rewisha ,&nbsp;Imam Waked","doi":"10.1016/j.ajg.2025.04.002","DOIUrl":"10.1016/j.ajg.2025.04.002","url":null,"abstract":"<div><div>Splenic siderotic foci are scar tissue composing freckles, usually less than 1 cm. They turn reflective after further deposition of calcium. These foci are also known as Gamna-Gandy bodies and are most encountered in severe and long-standing portal hypertensive – congestive splenomegaly. Herein, we present a case of an unusual sonographic depiction of reflective foci wholly embracing an average-sized spleen and imposing a clinical dispute.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"26 3","pages":"Pages 311-313"},"PeriodicalIF":1.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530460","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}

{"title":"Esophageal localized muscular defect observed during endoscopic submucosal dissection","authors":"Shinya Taki,&nbsp;Mikitaka Iguchi,&nbsp;Masayuki Kitano","doi":"10.1016/j.ajg.2025.01.001","DOIUrl":"10.1016/j.ajg.2025.01.001","url":null,"abstract":"","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"26 3","pages":"Pages 308-310"},"PeriodicalIF":1.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081415","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}

{"title":"The efficacy and safety of venous thromboembolism prophylaxis among hospitalized cirrhotic patients: Systematic review and meta-analysis","authors":"Abdel-Naser Elzouki ,&nbsp;Mohamed Nabil Elshafei ,&nbsp;Islam Elzouki ,&nbsp;Munir Abu-Ageila ,&nbsp;Muhammad Aamir Waheed ,&nbsp;Elmukhtar Habas ,&nbsp;Suhail Doi ,&nbsp;Mohammed I. Danjuma","doi":"10.1016/j.ajg.2025.01.010","DOIUrl":"10.1016/j.ajg.2025.01.010","url":null,"abstract":"<div><h3>Background and study aims</h3><div>This meta-analysis aims to evaluate the effect of prophylactic anticoagulation on incidence of venous thromboembolism (VTE), bleeding events, and mortality in hospitalized cirrhotic patients.</div></div><div><h3>Methods</h3><div>We utilized the following databases (EMBASE, PubMed, MedRxiv and google-scholar) to search for studies that satisfied the reviewers pre-specified inclusion criteria. The incidence of VTE, bleeding risks, and mortality were assessed using a quality effect meta-analytic model.</div></div><div><h3>Results</h3><div>From screening of 539 studies, a total of 9 studies (n = 6275 patients) satisfied inclusion criteria. Our results suggested no significant difference in the primary outcome of VTE events in both groups of cirrhotic patients who received and did not receive anticoagulation for VTE prophylaxis, (OR:0.9, 95 % CI:0.50–1.62). Similarly, there was a non-significant reduced risk of bleeding events in hospitalized cirrhotic amongst patient cohorts receiving VTE prophylaxis compared to those who did not (OR:0.51, 95 % CI:0.22–1.14). Analysis of three studies showed no significant difference in mortality in both groups (OR 1.02, 95 % CI:0.8–1.31).</div></div><div><h3>Conclusion</h3><div>In a pooled examination of studies evaluating outcomes in patients exposed to VTE prophylactic anticoagulation, we found no significant difference in the burden of VTE or mortality between treated and untreated patients with chronic liver disease (CLD). The retrospective design of a plurality of studies enrolled in the review meant further prospective studies are needed to objectively ascertain the efficacy and safety of VTE prophylaxis amongst patient cohorts with CLD.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"26 3","pages":"Pages 234-240"},"PeriodicalIF":1.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053427","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}

{"title":"Choroidal vascular alterations in patients with Helicobacter pylori gastritis","authors":"Ali Küçüködük ,&nbsp;Enver Avcı","doi":"10.1016/j.ajg.2025.04.004","DOIUrl":"10.1016/j.ajg.2025.04.004","url":null,"abstract":"<div><h3>Background and study aims</h3><div>This study aims to examine the impact of Helicobacter pylori (<em>H. pylori</em>) gastritis, a condition that induces chronic inflammation in the body, on subfoveal choroidal thickness (SFCT) and choroidal vascular index (CVI) measurements.</div></div><div><h3>Patients and methods</h3><div>In this prospective study, data were collected from 76 patients who visited the gastroenterology clinic, had their <em>H. pylori</em> diagnosis confirmed through gastric biopsy, and had not yet received treatment. An additional 76 age- and gender-matched healthy individuals formed the control group. Subfoveal choroidal thickness (SFCT) was measured using enhanced depth imaging optical coherence tomography (EDI-OCT) (Spectralis, Heidelberg Engineering, Heidelberg, Germany). CVI measurements were obtained by dividing the subfoveal choroidal area in the EDI-OCT images into luminal and stromal areas using the image binarization technique.</div></div><div><h3>Results</h3><div>The mean SFCT was 359.14 ± 24.23 µm in the H. pylori-positive group and 353.62 ± 12.78 µm in the control group, with no statistically significant difference between the groups (p = 0.782). Similarly, the choroidal vascular index (CVI) was 0.63 in the H. pylori group and 0.62 in the control group, with no significant difference observed (p = 0.08).</div></div><div><h3>Conclusion</h3><div>Results indicate that SFCT and CVI measurements do not undergo significant changes during the active phase of <em>H. pylori</em> infection compared to the control group.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"26 3","pages":"Pages 250-253"},"PeriodicalIF":1.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021617","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}

{"title":"Quality of life and depressive state in patients with celiac disease: A case-control study","authors":"Irem Unalcin ,&nbsp;Suleyman Ersoy ,&nbsp;Emin Pala ,&nbsp;Velittin Selcuk Engin","doi":"10.1016/j.ajg.2025.03.004","DOIUrl":"10.1016/j.ajg.2025.03.004","url":null,"abstract":"<div><h3>Background and study aims</h3><div>The objective of this study was to evaluate the quality of life (QoL) of celiac patients, their predisposition to depression, and possible related factors.</div></div><div><h3>Patients and methods</h3><div>The study was planned as a case-control study and conducted between May 2023 and August 2023 at Umraniye Training and Research Hospital, Istanbul. The study included 81 patients with celiac disease (CD) aged 18–65 years who were followed up at the Gastroenterology outpatient clinic and 79 healthy controls who were admitted to the Family Medicine Outpatient Clinic. Participants were administered the Celiac Disease Questionnaire (CDQ), the World Health Organization Quality of Life Scale-Short Form (WHOQOL-BREF), and the Beck Depression Inventory (BDI). Statistical analysis was performed using SPSS 24 (Statistical Package for the Social Sciences).</div></div><div><h3>Results</h3><div>The study was conducted with 160 participants, of whom 73.8 % (n = 118) were female and 26.3 % (n = 42) were male. Age and gender distributions were similar. The celiac group had significantly lower scores of the WHOQOL-BREF “Overall Health” subscale compared to healthy controls (p = 0.004, Cohen’s d = 0.46). However, no significant differences were observed in other WHOQOL-BREF subscales or depression levels (p &gt; 0.05). In the celiac group, higher education levels (undergraduate and postgraduate) were associated with better QoL scores (η² = 0.11, p = 0.015), while lower education was linked to higher depression scores (p = 0.019). A strong negative correlation was found between CDQ scores and BDI scores (r = -0.529, p = 0.001), indicating that higher depression levels were associated with lower QoL.When controlled for confounding variables, gender and CD turned out to be independently related to overall health subscale scores.</div></div><div><h3>Conclusion</h3><div>In patients with CD, both the QoL scale CDQ and the WHOQOL-BREF scores were found to be ahead of the curve in our study. It was also observed that the WHOQOL-BREF scale “overall health” subscale score was lower in celiac patients, while other sub-parameters and depressive symptoms were comparable to healthy individuals The lower “Overall Health” subscale scores highlight the need for targeted interventions.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"26 3","pages":"Pages 272-280"},"PeriodicalIF":1.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022689","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}

{"title":"Changes of peripheral blood lymphocytes, neutrophils, CEA, TAP and ferritin in colorectal adenoma and colorectal cancer and the diagnostic performance of these makers in evaluating colorectal cancer","authors":"Jialai Zheng ,&nbsp;Yongtao Tu ,&nbsp;Haiyong Jin ,&nbsp;Haiyan Sun ,&nbsp;Guanqiao Shen ,&nbsp;Haijiang Tong","doi":"10.1016/j.ajg.2025.03.002","DOIUrl":"10.1016/j.ajg.2025.03.002","url":null,"abstract":"<div><h3>Background and study aims</h3><div>Colorectal cancer (CRC) has been recognized as a multifactorial disease arising from precursor lesions and characterized by chronic inflammation. Therefore, the inflammatory response is one of the critical indicators for the diagnosis of CRC. Timely and effective screening is an effective strategy to reduce the incidence and mortality of CRC. The primary aim of this study was to analyze the differences in white blood cell count (WBC) in patients with colorectal adenoma (CRA) and CRC. The second aim was to estimate the diagnostic performance of using a panel of serum tumor markers and WBC for CRC screen.</div></div><div><h3>Patients and methods</h3><div>We retrospectively reviewed a database of patients who were diagnosed with CRA and CRC. Serum tumor markers and blood routine examination data were completed before receiving any anticancer therapy.</div></div><div><h3>Results</h3><div>A total of 538 participants were enrolled, including 169 health participants, 195 patients with CRA and 174 patients with CRC. Lymphocyte counts were lower in CRC than CRA and healthy participants. Neutrophil counts were higher in CRC and CRA than healthy participants. The CEA levels were higher in CRA and CRC than healthy participants, and higher in CRC than CRA. The areas of tumor TAP were larger in CRC than CRA and healthy participants. The ferritin levels were lower in CRC than CRA and healthy participants. The 8-marker panel yielded an AUC of 0.854 higher than single marker. There is no difference in the diagnostic performance of TAP, CEA, ferritin and NLR.</div></div><div><h3>Conclusions</h3><div>There are a lot of high sensitivity and specificity methods for CRC screening. However, most screening programs suffer from poor participation rates. Herein, our 8-marker panel is cost-effective and high-performance screen system for the detection of CRC and is crucial for enhancing the participation rates in current screening programs.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"26 3","pages":"Pages 286-291"},"PeriodicalIF":1.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062909","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}

{"title":"Comparison of 12- and 15-mm endoscopic papillary large balloon dilation combined with a limited endoscopic sphincterotomy for large bile duct stones: A propensity score-matched analysis","authors":"Qian Zhang ,&nbsp;Lili Chen ,&nbsp;Jun Liu ,&nbsp;Weiwei Chen ,&nbsp;Meng Zhou ,&nbsp;Chaowu Chen","doi":"10.1016/j.ajg.2025.03.003","DOIUrl":"10.1016/j.ajg.2025.03.003","url":null,"abstract":"<div><h3>Background and study aims</h3><div>Endoscopic papillary large balloon dilation (EPLBD) combined with endoscopic sphincterotomy (EST) has been increasingly used to remove large common bile duct (CBD) stones. However, the clinical outcomes of stone extraction have rarely been investigated in regard to the size of the balloon. The aim of this study was to assess the short- and long-term outcomes of 12- and 15-mm EPLBD with a limited EST for large CBD stones.</div></div><div><h3>Patients and methods</h3><div>Patients without prior endoscopic retrograde cholangiopancreatography (ERCP) who received 12- or 15-mm EPLBD in combination with a limited EST for large CBD stones at our center between January 2013 and December 2020 were recruited. Matched pairs with 12- and 15-mm EPLBD were generated.</div></div><div><h3>Results</h3><div>A total of 161 patients were included, with 50 patients successfully matched in each group. The total procedure time (36.8 min vs. 47.3 min, <em>p</em> = 0.003) and the tone removal time (30.5 min vs. 39.2 min, <em>p =</em> 0.008) were significantly lower in the matched 15-mm EPLBD group, while the initial and overall stone removal success rates were comparable between the two groups (<em>p</em> &gt; 0.05). The matched 15-mm EPLBD group had a lower incidence of post-ERCP pancreatitis (PEP) compared to the matched 12-mm EPLBD group (2.0 % vs. 16.0 %, <em>p</em> = 0.031). The cumulative long-term biliary complications were not statistically different between the two groups (log-rank test <em>p</em> = 0.612).</div></div><div><h3>Conclusion</h3><div>15-mm EPLBD combined with a limited EST shortened the procedure time and reduced the incidence of PEP without increasing long-term biliary complications compared to 12-mm EPLBD combined with a limited EST.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"26 3","pages":"Pages 281-285"},"PeriodicalIF":1.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026309","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}