Turkish Journal of Gastroenterology最新文献

Background/aims: This study aimed to assess the efficacy and safety of endoscopic full-thickness resection (EFR) in comparison to cap-aspiration lumpectomy (CASL) for treating small gastrointestinal (GI) stromal tumors (GISTs).

Materials and methods: A retrospective analysis was carried out on the data from elderly patients (66 cases) with small gastric GISTs who were treated with EFR (41 cases) or CASL (25 cases). The study compared the clinical features, surgical conditions, intraoperative and postoperative complications, postoperative efficacy, economic benefits, and follow-up of small gastric GISTs in the EFR and CASL groups.

Results: The mean operative time for the EFR group was longer than that for the CASL group [45.0 (32.5, 66.5) minutes versus 30.0 (20.0, 42.5) minutes]; the resection time in the EFR group was higher than that in the CASL group [30.0 (20.0, 50.5) versus 9.0 (6.5, 16.5) minutes]; the rate of utilization of hot hemostatic forceps in the EFR cohort was higher than that observed in the CASL cohort [75.6% (31/41) versus 12.0% (3/25)]; the postoperative course of antibiotics was longer in the EFR group than in the CASL group [(2.8 Å} 2.0) d versus (1.0 Å} 2.0) d]; and the hospitalization cost of the EFR group was extremely higher than that of the CASL group [(¥13 595.0 Å} 2653.3) versus (¥11 209.0 Å} 2458.9)].

Conclusion: EFR and CASL are safe and effective in the treatment of small gastric GISTs, and CASL is more suitable for the treatment of small gastric GISTs located in the gastric fundus and body in elderly patients.   Cite this article as: Ye L, Huang B, Yi X, Cai H. Comparison between efficacy of EFR and CASL in the treatment of small gastric stromal tumors: A retrospective study. Turk J Gastroenterol. 2026;37(1):35-43.

Background/aims:   The  prevalence  of  metabolic  dysfunction-associated  steatotic  liver  disease  (MASLD)  is  increasing  globally.  The  Fibrosis-4 (FIB-4) score is a noninvasive biomarker used for assessing potential advanced fibrosis. The study aimed to evaluate the role of the FIB-4 score in predicting postoperative complications and mortality in patients undergoing surgery.

Materials and methods: This multicenter retrospective study included 11 072 patients who underwent surgery under general anesthesia. Demographic and clinical data-including age, gender, comorbidities, FIB-4 scores, American Society of Anesthesiologists classification, postoperative complications, and mortality-were analyzed.

Results:   A  total  of  1667  MASLD  patients  were  included.  Patients  were  classified  based  on  FIB-4  scores:  70%  (n  =  1167)  had  FIB-4  <1.30, 25.1% (n = 418) had 1.30 < FIB-4 ≤ 2.67, and 4.9% (n = 82) had FIB-4 ≥ 2.67. Due to the limited number of patients with possible advanced fibrosis (FIB-4 ≥ 2.67), propensity score (PS) matching was performed. After PS matching, patients with a high FIB-4 score exhibited a significantly higher rate of postoperative complications (P < .001), and 12-month mortality was elevated (11%), although the difference was not statistically significant (P = .481).

Conclusion: A high FIB-4 score may serve as a predictive marker for postoperative complications in patients with MASLD undergoing surgery. Cite this article as: Eren F, Goktug MR, Ari D, et al. Fibrosis-4 score and postoperative outcomes in metabolic dysfunction-associated steatotic liver disease. Turk J Gastroenterol. 2026;37(1):127-135.

Background/aims: Inflammatory bowel disease (IBD) is a chronic, increasingly common condition linked to other autoimmune disorders, including vitiligo. This study aims to assess IBD co-occurrence in vitiligo patients to explore underlying immunogenetic factors and inform better screening and management.

Materials and methods: A systematic search was conducted across Scopus, PubMed/Medline, Web of Science, and Embase, to identify relevant studies published up to March 31, 2025. Studies examining the prevalence of IBD and its subtypes in patients with vitiligo wereincluded. Data were extracted and pooled using random effects models, with heterogeneity assessed through Cochran's Q test andHiggins I2 test.

Results: A total of 16 studies with 44 records were included in the analysis. The pooled prevalence of IBD was 0.97% (95% CI: 0.69-1.25),with Crohn's disease (CD) and ulcerative colitis (UC) reported at 0.45% (0.32-0.59) and 0.69% (0.42-0.97), respectively. Also, vitiligowas significantly associated with an increased risk of IBD (odds ratio [OR] = 1.51, 95% CI: 1.10-2.07), particularly for CD (OR = 1.49, 95%CI: 1.13-1.97). The pooled prevalence of IBD varied across countries, with the highest prevalence reported in Saudi Arabia. Additionally,women with vitiligo had a slightly higher pooled prevalence of IBD compared to men.

Conclusion: This study found that the prevalence of IBD in patients with vitiligo is approximately 0.97%, with vitiligo significantly increasing the risk of developing IBD, particularly CD. Clinicians should consider IBD in the differential diagnosis of vitiligo patients withgastrointestinal symptoms.   Cite this article as: Gu Z, Teng J. Co-occurrence of inflammatory bowel disease in patients with vitiligo: a systematic review and meta-analysis. Turk J Gastroenterol. 2026;37(1):3-14.

Background/aims: Malnutrition is a serious problem in patients with liver cirrhosis; therefore, it is recommended that nutritional screening should be performed regularly with appropriate nutritional screening tools (NSTs). This study aimed to compare the efficacy of the Nutritional Risk Score-2002 (NRS-2002) and Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) NSTs in detecting malnutrition in liver cirrhosis patients.

Materials and methods: This study was conducted with cirrhotic patients (n = 149). The NRS-2002 and RFH-NPT scales were used to assess the nutritional status of patients, and anthropometric measurements were taken. Biochemical findings of patients were recorded. The Chronic Liver Disease Life Quality Scale 2.0 (CLDLQS 2.0) was used to determine the quality of life.

Results: According to both NSTs, patients with nutritional risk had lower body weight, body mass index, albumin levels, higher C-reactive protein levels, and quality of life scores than patients without nutritional risk (P < .05). The sensitivity and specificity of the RFH-NPT were 91.5% and 63.3%, respectively. Albumin was more effective in predicting nutritional risk than other biochemical parameters. The RFH-NPT was found to be more correlated with biochemical parameters than NRS-2002.

Conclusion: The RFH-NPT is highly effective in detecting malnutrition and correlates with biochemical parameters in cirrhotic patients.   Cite this article as: Calapkorur S, Canaydin AO, Sezgin GC, Sahin H. Comparison of the effectiveness of Nutritional Risk Score-2002 and Royal Free Hospital-Nutritional Prioritizing Tool nutrition screening tools in liver cirrhosis. Turk J Gastroenterol. 2026;37(1):121-126.

Background/aims: Acute pancreatitis is a life-threatening disease associated with significant in-hospital mortality, particularly when complications occur. However, there is little data for long-term all-cause mortality of acute pancreatitis and its relation to etiology. Thus, in this study, both short- and very long-term all-cause mortality after acute pancreatitis were sought.

Materials and methods: Patients admitted with acute pancreatitis to the Bezmialem Vakıf University Hospital from 2012 to 2023 were retrospectively investigated. Demographic and laboratory values were obtained from hospital records. All-cause mortality was assessed using the national death notification system.

Results: A total of 689 patients were included in the final analysis. The median follow-up duration was 86 months (range: 0-154 months). The mean age of the study population was 54.3 ± 16.9 years, and 384 individuals (55.7%) were women. The overall in-hospital mortality rate was 2.8%, while 1-year all-cause mortality was 5.4%. Age, diabetes mellitus, and development of in-hospital complications were independent predictors of all-cause long-term mortality. In terms of etiology, alcoholic and hypertriglyceridemia-induced acute pancreatitis had higher in-hospital mortality rates; however, over the long term, alcoholic pancreatitis yielded the worst prognosis. The first year after discharge showed the highest mortality that is most likely associated with in-hospital complications and disease severity.

Conclusion: This study sheds light on modern-era mortality rates of acute pancreatitis. Age, diabetes, and in-hospital complication development had a significant impact on long-term survival. Although underrepresented in this cohort, alcoholic pancreatitis had the highest long-term all-cause mortality and clearly represents an issue that deserves to be investigated.

Background/aims: Acute pancreatitis is a life-threatening disease associated with significant in-hospital mortality, particularly when complications occur. However, there is little data for long-term all-cause mortality of acute pancreatitis and its relation to etiology. Thus, in this study, both short- and very long-term all-cause mortality after acute pancreatitis were sought.

Materials and methods: Patients admitted with acute pancreatitis to the Bezmialem Vakıf University Hospital from 2012 to 2023 were retrospectively investigated. Demographic and laboratory values were obtained from hospital records. All-cause mortality was assessed using the national death notification system.

Results: A total of 689 patients were included in the final analysis. The median follow-up duration was 86 months (range: 0-154 months). The mean age of the study population was 54.3 ± 16.9 years, and 384 individuals (55.7%) were women. The overall in-hospital mortality rate was 2.8%, while 1-year all-cause mortality was 5.4%. Age, diabetes mellitus, and development of in-hospital complications were independent predictors of all-cause long-term mortality. In terms of etiology, alcoholic and hypertriglyceridemia-induced acute pancreatitis had higher in-hospital mortality rates; however, over the long term, alcoholic pancreatitis yielded the worst prognosis. The first year after discharge showed the highest mortality that is most likely associated with in-hospital complications and disease severity.

Conclusion: This study sheds light on modern-era mortality rates of acute pancreatitis. Age, diabetes, and in-hospital complication development had a significant impact on long-term survival. Although underrepresented in this cohort, alcoholic pancreatitis had the highest long-term all-cause mortality and clearly represents an issue that deserves to be investigated.

Background/aims: The aim of this study is to investigate whether the creeping fat (CF) finding evaluated by computed tomography (CT) can be used as a noninvasive marker to predict disease prognosis.

Materials and methods: The study comprised 128 Crohn's patients, aged 18-70, who had CT scanning for a variety of reasons. Patients were retrospectively analyzed in 3 groups (31 patients with operation due to stenosis, 39 patients with unoperated stenosis, and 44 patients without stenosis). The CF Index BSACR (bowel surface area coverage ratio), CF density, and visceral-subcutaneous fat ratio (VSFR) findings were evaluated by CT compared between the groups.

Results: The median VSFR was higher in the stenosed group compared to the non-stenosed group (0.7 vs 0.4; P = .003). The CF index BSACR was 37.5% (27.1% vs 18.2%; P = .001), and the rate of those with a CF index BSACR above 37.5% was higher in those with stenosis compared to those without. The odds of stenosis were 17.07 times (odds ratio [OR] = 17.07; P = .007) higher in those with a CF index BSACR of 37.5% and 184.57 times (OR = 184.57; P = .001) higher in those with a CF index BSACR of 50% or more compared to those with no involvement or a CF index BSACR of 25% or less.

Conclusion: The CF index correlated with stricturing disease and may be a noninvasive radiologic marker that predicts disease prognosis.

Cite this article as: Kemik F. The role of pancreatic enzyme insufficiency in the etiology of functional dyspepsia resistant to standard treatment. Turk J Gastroenterol. 2026;37(1):144-145.

Cite this article as: Feng J, Zhai Y, Liu Z, Linghu E. Novel endoscopic suture anchor device for large defect closure following endoscopic submucosal dissection. Turk J Gastroenterol. 2026;37(1):136-138.

Background/aims: Patients with hepatitis B-related decompensated cirrhosis may achieve recompensation. The alanine aminotransferase (ALT) to quantitative hepatitis B surface antigen (qHBsAg) ratio is a novel predictor for hepatitis B surface antigen (HBsAg) seroclearance. This study evaluates its utility in predicting recompensation based on Baveno VII criteria.

Materials and methods: Decompensated hepatitis B-related cirrhosis patients were recruited and received antiviral treatment for at least 12 months. Classification of these participants into the decompensated and recompensated groups was established according to the Baveno VII criteria. Logistic regression and subgroup analysis assessed the correlation between the ratio of ALT to qHBsAg at baseline and cirrhotic recompensation.

Results: A total of 136 patients were involved in this study; 80 (58.8%) patients achieved recompensation. Univariate analysis associated recompensation with sex, age, ALT, aspartate aminotransferase, hepatitis B virus DNA (HBV DNA), qHBsAg, and ALT/logqHBsAg. Multivariate analysis confirmed that higher ALT/logqHBsAg independently predicted greater recompensation likelihood (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 1.00~1.02; P = .027). Categorically, ALT/logqHBsAg > 23.48 significantly increased recompensation probability (OR = 3.21, 95% CI = 1.31~7.90, P = .011). Subgroup analyses across 7 pre-specified subgroups (sex, age, hepatitis B e antigen, HBV DNA, Child-Pugh grade, Model for End-Stage Liver Disease score, qHBsAg) demonstrated consistent relationships. Enhanced predictive power was observed in Child-Pugh class C versus classes A/B and in males versus females.

Conclusion: Elevated baseline ALT/logqHBsAg predicts a higher likelihood of hepatic recompensation in hepatitis B-related cirrhosis under Baveno VII criteria.