Journal of Digestive Diseases

Publisher: Chinese Society of Gastroenterology, Wiley

Journal description

Current impact factor: 1.92

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 1.924
2012 Impact Factor 1.853
2011 Impact Factor 1.589
2010 Impact Factor 1.87
2009 Impact Factor 1.791

Impact factor over time

Impact factor
Year

Additional details

5-year impact 1.81
Cited half-life 2.80
Immediacy index 0.28
Eigenfactor 0.00
Article influence 0.49
Other titles Journal of digestive diseases (Online)
ISSN 1751-2980
OCLC 123124871
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Wiley

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    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
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  • Classification
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Publications in this journal

  • An Jiang Wang · Lu Xia Tu · Chen Yu · Xue Lian Zheng · Jun Bo Hong · Nong Hua Lu
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    ABSTRACT: Achalasia as the primary manifestation of acquired immunodeficiency disease (AIDS) is very rare. There are isolated case reports of AIDS patients presenting with dysphagia symptoms caused by opportunistic infections, such as such as candida, cytomegalovirus, or herpes simplex virus. Here we reported a case of patient with AIDS, who was diagnosed as achalasia by high resolution impedance manometry and recovered only by the combination of antiretroviral and anti-TB therapy. The findings in this patient suggest that HIV may cause achalasia through both neurotrophic effect and opportunistic infection infectious agents. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 09/2015; DOI:10.1111/1751-2980.12287
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    ABSTRACT: Endoscopic resection of a foregut neuroendocrine tumor (NET) is increasingly performed instead of surgery. This study aimed to verify the long-term therapeutic results of endoscopic resection (ER) and surgical resection (SR) in foregut NETs. From 2002 to 2012, a total of 49 patients were confirmed histologically as foregut NETs treated by ER (stomach = 19, duodenum = 14) and SR (stomach = 11, duodenum = 5). The clinicopathological characteristics and therapeutic outcomes were evaluated. Of the 33 patients who underwent ER (endoscopic mucosal resection = 26, endoscopic mucosal dissection = 7), 32 cases were diagnosed as type NET-G1 and one case as neuroendocrine carcinoma (NEC). Of the 16 patients who underwent SR, 10 were diagnosed as NET-G1, two as NET-G2 and four as NEC. The median tumor size was significantly smaller in ER than SR patients (0.7 cm vs. 1.9 cm, p = 0.001). In almost all ER patients (32/33 cases), NET invasion was limited to mucosa and submucosa. Non-curative resections were achieved in eight ER patients (8/33, 24.2%) and in four SR patients (4/16, 25%). No recurrence occurred in seven NET cases defined as non-curative resection with positive resection margins by ER; however, all cases of non-curative resection with lymphatic invasion (ER = 1, SR = 4) experienced recurrence during the follow up period despite complete resections. They were all NEC histologically. ER may have a good prognosis if the tumor size is small and histologically low-grade without lymphatic invasion. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12279
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    ABSTRACT: Ulcerative colitis (UC) is a chronic inflammatory disease of the mucosa of the large intestine. The treatment of UC depends on the severity of symptoms and on the extent of the disease. Acute Severe Colitis (ASC) occurs in 12-25%. Patients with Acute Severe Colitis must be managed by a multidisciplinary team. A medical or surgical aggressive treatment is carried out with the final aim of reducing mortality. Intravenous corticosteroids are the mainstay of the therapy. Medical rescue therapy based on Cyclosporine or Infliximab should be considered if there is no response to corticosteroids after 3 days. In the event that there has been no response to medical rescue therapy after 4-7 days, the patient must undergo a colectomy surgery in urgency. Prolonged observation is counterproductive, as over time it increases the risk of toxic megacolon and of perforation, burdened with a very high mortality rate. The best possible treatment is a subtotal colectomy with ileostomy and preservation of the rectum. Emergency surgery in UC should not be seen as a last chance, but can be considered as a life-saving procedure. Colectomy in an emergency setting is characterized by high morbidity rates but the mortality is low. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12278
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    ABSTRACT: There is a considerable high prevalence of vitamin D deficiency, which is defined by the serum level of 25-hydroxyvitamin D [25(OH)D] lower than 20 ng/ml, in all populations of the world. Unfortunately, the prevalence of vitamin D deficiency in patients with intestinal malabsorption syndromes, including cystic fibrosis (CF), celiac disease (CD), short bowel syndrome, and inflammatory bowel disease (IBD), is higher than that in the general population, indicating the presence of disease-specific causative factors. In this review, we aim to present clinical findings to highlight the roles of insufficient sunlight exposure and inflammation in the development of vitamin D deficiency in patients with intestinal malabsorption syndromes. Also, we aim to present experimental evidence that supports a role of vitamin D deficiency in the pathogenesis of IBD. Finally, we review clinical intervention strategies that aim to normalize vitamin D status in and/or even improve the conditions of patients and discuss certain issues that need to be addressed in future research. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12283
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    ABSTRACT: The aim of this study was to evaluate the efficacy of esophageal self-expanding metal stent (E-SEMS) insertion for malignant esophageal obstruction (MEO) in patients with or without additional palliative treatments. We retrospectively reviewed the medical records of the patients with E-SEMS for MEO at Seoul National University Hospital. Baseline characteristics, changes of Mellow-Pinkas score about dysphagia, and complications were compared between two groups. A total of 236 E-SEMS were inserted to 192 patients (esophageal cancer 46.4%, gastric cardia cancer 33.3%, lung cancer 15.1%). Mellow-Pinkas score significantly decreased in 1 week (1.66 ± 0.79, P = 0.000) and 1 month (1.71 ± 0.87, P = 0.000) after the insertion of E-SEMS (3.09 ± 0.79). Complications occurred in 54 cases (22.9%); 28 stent obstruction (11.9%), 5 perforation (2.1%), 10 stent migration (4.2%), 5 tracheoesophageal fistula (2.1%), no procedure-related death (0.0%). Most complications were managed with insertion of additional SEMS (74.1%). The risk of stent obstruction was significantly higher in uncovered SEMS than covered (OR 4.31, 95%CI 1.75-4.52, P = 0.001). Mean interval to the development of complication was 74.8 ± 111.1 days. Overall survival (169.0 ± 127.8 days vs. 96.4 ± 90.6 days, P = 0.000) and stent patency (143.3 ± 123.9 days vs. 67.6 ± 71.3 days, P = 0.000) were significantly favorable in the patients with E-SEMS and additional palliative treatments than E-SEMS alone. E-SEMS insertion could be effective and safe for MEO, and the additional palliative treatment might lengthen stent patency by extension of survival. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12280
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    ABSTRACT: Gastric cancer is a typical type of inflammation-related tumor. p42.3 gene highly expresses in gastric cancer but whether it is associated with gastritis is still unknown. Here we will explore the relationship between inflammation and p42.3 gene. Normal gastric epithelium cells (GES-1) were treated with H. pylori and tumor necrosis factor alpha (TNF-α) separately. Total cell mRNA and protein were collected and PCR and western blotting were conducted to determine the relative expression of p42.3 gene. 291 chronic non-atrophic gastritis tissue samples were collected and immunohistochemistry method was used to measure the rate of p42.3 protein expression. The associations between p42.3 protein and the clinicopathological characteristics of patients with chronic non-atrophic gastritis were analyzed. H. pylori can significantly enhance the p42.3 protein expression in GES-1 cells. Moreover, inflammatory cytokines TNF-α can stimulate the p42.3 gene expression in GES-1 cells and further the effect showed a time and dose dependent manner. In addition, the p42.3 gene expression was positively associated with the gastric mucosa inflammation degree and H. pylori infection (P = 0.000). Its expression rate was significantly high in gastric mucosa with severe inflammation and in H. pylori infection cases. The p42.3 gene expression is associated with the gastric mucosa inflammation and it can be stimulated by TNF-α and H. pylori respectively. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12282
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    ABSTRACT: Research on inflammatory bowel disease (IBD) highlighted genes involved in the regulation of inflammatory responses as contributors to disease pathogenesis. Objective of this study was to evaluate associations between IBD and variations in NOD2, TLR4, TNF-α, IL-6, IL-1β, IL-1RN genes, and to use obtained genetic data in predictive modeling. We genotyped 167 IBD patients and 101 healthy donors by PCR-RFLP procedure. Using attained genotype data as input to various classification algorithms, we designed IBD prediction models. Area under the receiver operating curve (AUC) was used as measure of their performance. Significant associations were found between Crohn's disease (CD) and NOD2 minor variants, as well as TLR4 299Gly, TNF-α -308A, IL-6 -174C and IL-1RN VNTR A2 variants, while ulcerative colitis (UC) was associated only with IL-1RN VNTR A2. CD and UC showed highly significant difference in allelic distribution of TNF-α G-308A, where A allele was found to be related to CD, and G allele to UC occurrence. Among CD patients, combined effect of gender and TLR4 variants was observed. When all analyzed genotype and gender data were used, prediction performance achieved maximum AUC of 0.69 for CD and 0.60 for UC dataset. These results showed that variations in genes involved in immune regulation are genetic factors of importance in IBD susceptibility that can be used as predictors of disease development. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 08/2015; DOI:10.1111/1751-2980.12281
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    ABSTRACT: Up to 100 trillion bacteria are harbored in the human intestine in a mutualistic and interdependent relationship with the host during a long period of co-evolution. The so-called intestinal microbiota (IM) fulfill important metabolic tasks and the impaired stability may lead to the microbiota-related diseases, including inflammatory bowel disease (IBD), colorectal cancer (CRC), metabolic syndromes (MS), liver diseases, et al. Here, we review the past and development of IM research in China, including achievements that Chinese researchers have made both in basic and clinical scientific field. Moreover, we evaluate the contributions of the National Natural Science Foundation of China (NSFC), the 973 National Basic Research Program of China (973 Program), the 863 National High Technology Research and Development Program of China (863 Program), and funds from the public health industry in the field of IM research. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 07/2015; DOI:10.1111/1751-2980.12274
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    ABSTRACT: Helicobacter pylori (H. pylori) antibiotic resistance has increased worldwide. Because antibiotic resistance is the major cause of eradication failure, alternate therapies are needed. To evaluate in vitro susceptibility and resistance patterns for antibiotics used in empirical H. pylori infection regimens, to determine the optimal antibiotics for eradication. H. pylori strains (n=181) were obtained from gastric biopsies of patients with upper-gastrointestinal symptoms who underwent esophagogastroduodenoscopies from March to December, 2013. Amoxicillin (AMX), metronidazole (MTZ), clarithromycin (CLR), amoxicillin-clavulanate (AMC), cephalothin (CEP), cefuroxime (CXM), cefixime (CFM), moxifloxacin (MFX), and minocycline (MNO) susceptibility was determined. H. pylori resistance rates and MIC90 results were: AMX, 3.87%, 0.032 mg/L; MTZ, 61.33%, >256 mg/L; CLR, 30.94%, 256 mg/L; AMC, 0%, 0.023 mg/L; CEP, 1.10%, 0.094 mg/L; CXM, 0%, 0.047 mg/L; CFM, 0.55%, 0.125 mg/L; MFX, 74.03%, 32 mg/L; and MNO, 6.63%, 8 mg/L. Dual resistance to MTZ+CLR was detected in 48 isolates (26.52%), MTZ+MFX in 94 isolates (51.93%), and CLR+MFX in 49 isolates (27.07%). 41 isolates (22.56%) resistant to MTZ+CLR+MFX. MTZ and CLR resistance was significantly associated with the history of eradication, but there was no difference in MFX resistance rate between treated and untreated patients (P=0.674). No significant relationship existed between antibiotic resistance and gender, age, endoscopic findings, inflammation degree, or gastric mucosa atrophy. AMX, AMC, MNO and cephalosporins, but not MTZ, CLR and MFX, showed good in vitro anti-H. pylori activity. Among cephalosporins, cefuroxime was most active. H.pylori resistance is higher in the patients with histories of eradication. These results can help adapt treatment strategies. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 07/2015; DOI:10.1111/1751-2980.12271
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    ABSTRACT: We aimed to compare plasma pantoprazole levels between patients with type 2 diabetes mellitus and non-diabetic patients during helicobacter pylori eradication treatment and the effect of plasma pantoprazole level on treatment success rates. This study included 40 diabetic and 40 non-diabetic naïve H.pylori infected patients. Bismuth based standart quadruple treatment was used 14 days for H.pylori eradication in both group. Plasma Pantoprazole levels (PPL) were measured via Square-Wave Voltammetry method. H. pylori eradication rate (%60.0vs. %87.5,p=0.005) and the plasma Pantoprazole level was significantly lower in diabetic group (0.25±0.03 μgmL-1vs 0.34±0.03 μgmL-1, p<0.001). Patients with treatment failure had lower PPL (p<0.001). A ROC curve demonstrated that, PPL had a significant (p <0.0001) predictive value for H.pylori eradication success. This is the first study investigating PPL and its effect on H. Pylori eradication success in type 2 diabetic and nondiabetic patients. Diabetic patients had lower PPL that caused lower H.pylori eradication rates. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 07/2015; DOI:10.1111/1751-2980.12272
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    ABSTRACT: Syncytial giant cell hepatitis, commonly occurring in the pediatric population, is unusually rare in adults, diagnosed histologically by the presence of multinucleated cells in the liver. The literature has only recorded approximately one hundred cases in adults during the past two decades with malignancy rarely associated with giant cell hepatitis. Our patient is a 66-year-old female who was diagnosed with chronic lymphocytic leukemia (CLL) and subsequently developed syncytial giant cell hepatitis. While giant cell hepatitis is rare in adults, it is usually linked to viruses, autoimmune diseases, and medications. The association between CLL and giant cell hepatitis is rare with only three reported cases in the literature. The majority of cases report viral particles on electron microscopy and usually has a history of chemotherapy and hypogammaglobulinemia. Unlike other cases, our patient developed giant cell hepatitis in the absence of other confounding variables, such as viral particles on electron microscopy, chemotherapy treatments, or low immunoglobulin levels. The treatment for our patient was high dose corticosteroid and rituxan with improvement in liver enzymes. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 07/2015; DOI:10.1111/1751-2980.12273
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    ABSTRACT: The incidence of NSAID-induced enteropathy is currently increasing. However, the clinical predictor of small bowel bleeding (SBB) associated with NSAID-induced enteropathy are unknown. This study aimed to know the risk factors of SBB in chronic NSAID users. We retrospectively compared records of 147 patients receiving NSAIDs at a tertiary-care setting (31 cases with SBB and 124 controls without previous bleeding events) and analyzed clinical predictors of SBB. Thirty-one patients underwent capsule endoscopy to evaluate SBB, 74.2% of which demonstrated evidence of SBB. Non-invasive treatment was performed in 90.3% of patients. Multivariable logistic regression analysis revealed that presence of coronary artery disease (adjusted odds ratio [aOR], 12.4; 95% confidence interval [CI], 1.2-130.3; p=0.04), use of thienopyridine (aOR,16.9;95%CI,3.8-75.7;p<0.001), and prior use of rebamipide (aOR 0.3;95%CI,0.12-0.82;p=0.02) were independently associated with SBB in NSAID users. Coronary artery disease and co-use of thienopyridine were associated with SBB in NSAID users. In patients with coronary artery disease and co-use of thienopyridine, it is necessary for clinicians to monitor for occurrence of SBB when they prescribe NSAIDs. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 07/2015; DOI:10.1111/1751-2980.12269
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    ABSTRACT: MicroRNAs have recently emerged as novel regulators in liver fibrosis. miR-30c and miR-193 are involved in fibrotic remodeling processes and cancer development, respectively. However, their role in liver fibrosis is currently unknown. We analyzed the regulation of miRNAs in carbon tetrachloride (CCl4 )-induced liver fibrosis by microarray. Expression patterns of miR-193 and miR-30c were further confirmed in fibrotic liver samples obtained from two murine models of hepatic fibrosis and human tissues. On a functional level, miRNA-levels were analyzed in the context of transforming-growth-factor mediated activation of hepatic stellate cells (HSC). Finally, predicted targets were assessed for their role in fibrosis by transfecting murine HSC with miRNA mimics. Microarray analysis in murine fibrotic livers revealed a panel of 41 deregulated miRNAs. In addition to previously established miRNAs known to be regulated in liver fibrosis in a TGF-β-dependent manner (e.g. miR-29, miR-133, miR-199a-3p), we show here that miR-193 and miR-30c were specifically downregulated not only in experimental hepatofibrogenesis but also in human liver fibrosis, while they showed a reciprocal expression pattern after recovery from liver fibrosis. Functional experiments confirmed the TGF-β-dependent downregulation of these respective new miRNAs in HSC. Finally, we identified TGF-β2 and SNAIL1, important regulators of the extracellular matrix, as potential target genes of miR-193 and miR-30 in liver fibrosis. These results suggest that miR-30 and miR-193 are members of a network of miRNAs modifying the TGF-β-dependent regulation of ECM-related genes in HSCs in the manifestation and resolution of liver fibrosis. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 06/2015; DOI:10.1111/1751-2980.12266
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    ABSTRACT: The scarcity of the donor livers and the impractical nature of transplantation represent the biggest obstacles for the treatment of liver failure. Adipose-derived stem cells with their ability to differentiate into the hepatic lineage represent a reliable alternative cell source, with clear ethical and practical advantages. Moreover, adipose-derived stem cells can effectively repair liver damage by the dominant indirect pattern and increase the number of hepatocytes by the secondary direct pattern. In recent years, the development of the indirect pattern, which mainly includes immunomodulatory and trophic effects, has become a hot topic in the field of cell engineering. Therefore, adipose-derived stem cells are considered to be an ideal therapeutic stem cell for human liver regeneration. In this article, we review the advantages of adipose-derived stem cells in liver regeneration, and explore the underlying mechanisms. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 06/2015; DOI:10.1111/1751-2980.12268
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    ABSTRACT: Sorafenib is currently the only standard treatment for advanced hepatocellular carcinoma (HCC), though the response rate remains poor (4%). We compared the overall survival after hepatic arterial infusion chemotherapy (HAIC) versus sorafenib monotherapy for advanced HCC. This retrospective study enrolled 177 patients with advanced HCC and Child-Pugh A but free of extrahepatic metastasis. Patients were divided into the HAIC group (n=136, treated with HAIC) and sorafenib group (n=41, treated with sorafenib), and followed to death or withdrawal of therapy. Response to treatment and overall survival were compared. The proportion of patients who showed complete response (CR)/partial response (PR)/stable disease (SD)/progressive disease (PD) were 6/25/41/21% and 2/2/44/42% in the HAIC and sorafenib groups, respectively. The response rate was better in HAIC group (31%) than sorafenib group (4%). The median survival time was 10 months in both HAIC and sorafenib groups. There was no difference in overall survival between the two groups. In patients with macroscopic vascular invasion (MVI) by the case-control method, the response rate was higher for the HAIC group (31%) than sorafenib group (0%). The overall survival was better in the HAIC group (14 months) than sorafenib group (7 months, p=0.005). Multivariate analysis identified MVI (hazard ratio 2.4, p=0.018) as a significant and independent determinant of survival in the sorafenib group. The response rate of HAIC was higher than that of sorafenib monotherapy. Prognosis was favorable in HAIC-responders despite MVI. HAIC might be desirable for advanced HCC patients free of extrahepatic metastasis. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 06/2015; DOI:10.1111/1751-2980.12267
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    ABSTRACT: Eosinophilic esophagitis (EoE) is a disorder of the esophagus characterized by distinctive endoscopic and histologic features. Optimal treatment for EoE has not been defined. A systematic review and meta-analysis were performed to clarify the advantage of steroids therapy for EoE. PubMed, EMBASE, Medline, ISI Wed of Science and the Cochrane Database of Systematic Reviews were searched to obtain relevant randomized controlled trials (RCTs) with comparison of steroids and non-steroids therapy, and retrospective and prospective trials on steroids therapy for EoE till March 2013. RevMan 5.2 was used for analysis. Six RCTs fulfilled inclusion criteria for meta-analysis, with 193 subjects included; And another 2 RCTs, 3 prospective and 5 retrospective trials fulfilled criteria of systematic review. Meta-analysis showed topical steroids significantly decreased the mean and peak esophageal eosinophils (eos) count compared to the non-steroids therapy (MDmean = -23.41, 95%CImean -42.08∼ -4.73, P=0.01 and MDpeak = -51.27, 95%CIpeak -78.62∼ -23.92, P=0.0002). The decease of mean eos was more pronounced in the adult group and when steroids compared to the placebo group (P=0.02 and P= 0.002 respectively). And the decrease of peak eos count remained significant independent of patient age, types of steroids (P<0.05). There were 14 trials showing the efficacy of steroids on decreasing eos count, 10 trials showing improvement of symptoms, and 5 trials showing endoscopic improvement. Only mild adverse effects were reported for topical steroids. Steroids were effective on decreasing the mean and/ or peak eos count for EoE. Its value of improving symptoms and endoscopic changes was not yet determined due to lack of unified criteria. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 06/2015; DOI:10.1111/1751-2980.12265
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    ABSTRACT: The incidence of early esophageal adenocarcinoma has increased significantly in the last decades. Prognosis is highly dependent on the choice of treatment. Early stages can be treated by endoscopic resection, whereas advanced carcinomas have to be sent to surgery. Esophageal resection is associated with high perioperative mortality (1-5%) even in specialized centers. Early diagnosis enables a curative endoscopic treatment option. Patients with gastrointestinal symptoms and familial risk for esophageal cancer should undergo an upper GI-endoscopy. Technical progress has developed high definition endoscopes and technical add-ons which help endoscopists to find fine irregularities in the esophageal mucosa but interpretations still remain challenging. In this review we discuss the novel and old diagnostic procedures and their value, as well as the actual recommendations in diagnose and treatment of early Barrett's carcinoma. Database of Pubmed and Medline was searched and analysed to provide all relevant literature to this review Conclusion: Endoscopic resection is the therapy of choice in early adenocarcinoma of the esophagus. It is mandatory to perform subsequent ablation of all residual Barrett's mucosa to avoid metachronous lesions. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 06/2015; DOI:10.1111/1751-2980.12264
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    ABSTRACT: Regeneration of the partial allograft and the growth of children may cause kinking of the bile outflow tract after pediatric living donor liver transplantation (LDLT), but bile duct kinking after adult LDLT is rarely reported. We herein present our experience with treatments of two patients who suffered from anastomotic strictures caused by severe bile duct kinking after LDLT. The first patient was a 57-year-old woman with hepatitis B virus (HBV)-related liver cirrhosis, who developed a biliary stricture 5 months after receiving a right-lobe LDLT. Subsequently, endoscopic and percutaneous treatments were attempted, but they both failed to solve the problem. The second was a 44-year-old woman, and she also had HBV-related liver cirrhosis. A biliary stricture occurred 14 months after LDLT. Likewise, the guide wire failed to pass through the stricture site when endoscopic interventions were conducted. Afterwards, both of the two cases underwent reexploration. It was observed that compensatory hypertrophy of the allografts resulted in kinking and sharp angulation of the bile ducts, and the anastomotic sites were found to be severely stenotic. Finally, re-anastomosis by Roux-en-Y procedure was successfully performed, and long-term stenosis-free survival was achieved in both of them. Our experience suggests that bile duct kinking after LDLT may play a role in the high incidence of anastomotic strictures in adult LDLT recipients, which may also result in the treatment failure of the non-surgical techniques for anastomotic strictures. Re-anastomosis in the form of Roux-en-Y hepaticojejunostomy is an effective surgical option for the treatment of such a condition. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 06/2015; DOI:10.1111/1751-2980.12263
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    ABSTRACT: Thermal ablative therapies continue to acquire favor to be safe and effective for the treatment of patients with non resectable hepatocellular carcinoma. Percutaneous microwave ablative therapy which is a relatively new technique has the advantage in providing faster ablation of larger tumors. This study aimed to evaluate microwave ablation in treatment of large HCCs (5-7cm) and to assess its effect on local tumor progression, prognostic outcome and patient's survival. Twenty six patients with HCC lesions (5-7cm) were managed in our multidisciplinary clinic of Kasr Al Ainy University hospital using microwave ablation. It was performed with the patient under conscious sedation and analgesia, ultrasonography guided using HS AMICA microwave machine, operating at frequency of 2450 MHz and a power up to 100 W. Multiple needle insertions in one or two sessions according to the size of the lesion. Patients were assessed for efficacy and safety. Complete ablation rate, local tumor progression and overall survival analysis were evaluated. Complete ablation was achieved in (19/ 26; 73.1%) of the lesions. Local tumor progression was recorded in 5 treated lesions (19.2%). Distant tumor progression within the liver was recorded in 6 patients (23.1%), with a mean survival of 21.5 months. No major complications or deaths related to the procedure. Microwave ablation by percutaneous approach is safe and effective in the treatment of large HCC tumor. The survival and local tumor control were acceptable. This article is protected by copyright. All rights reserved.
    Journal of Digestive Diseases 05/2015; DOI:10.1111/1751-2980.12259