World Journal of Gastroenterology

BACKGROUND The rising detection of branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) has led to updated surveillance guidelines, yet the true malignant transformation rate and the cost-effectiveness of these strategies remain uncertain. Current protocols are based on expert opinion rather than validated data, leading to conflicting recommendations and significant healthcare costs. Th…

BACKGROUND Portal hypertension (PHT) is a complication of chronic liver disease. PHT was observed from the early stage of cholestatic liver disease (CLD). Growth arrest specific 6 (Gas6)-mediated macrophage efferocytosis was an essential process clearing apoptotic cells and facilitating liver injury repair. AIM To investigate the effects of recombinant Gas6 (rGas6) on efferocytosis in PHT based o…

BACKGROUND Although immune checkpoint inhibitors have shown remarkable efficacy in multiple malignancies, their clinical benefit remains limited in the majority of colorectal cancers (CRC). This resistance is attributed to CD8+ T cell exhaustion. The extracellular signal-regulated kinase (ERK)/p38 mitogen-activated protein kinase (p38 MAPK) pathway plays a pivotal role in both tumor progression a…

Immune contexture increasingly shapes colorectal cancer (CRC) prognosis, yet most profiling is tumor-centric. The study interrogated adjacent nontumor mucosa (NM) and tumor center (TC) in 99 CRC patients with liver metastases (LM). Using immunohistochemistry for CD68 (M0), CD80 (M1), and CD206/CD163 (M2), they observed a consistent density gradient (CD163 > CD206 > CD68 > CD80) and marke…

BACKGROUND Acute pancreatitis (AP) is a common disease in the intensive care unit. Although the clinical management of AP has improved, over mortality has not declined significantly. Rhubarb, an anthraquinone glycoside derivative, has been reported to improve intestinal blood perfusion, inhibit excessive inflammatory responses, regulate inflammatory mediator cascades, and enhance intestinal motil…

BACKGROUND Liver inflammatory lesions and malignancies often have overlapping manifestations and contrast-enhanced ultrasound (CEUS) enhancement modes, particularly in hepatitis or cirrhosis settings. Conventional biomarkers, such as alpha-fetoprotein (AFP) and the Model for End-Stage Liver Disease (MELD) score, have limited diagnostic accuracy in this setting. Therefore, an interpretable, multi-…

BACKGROUND While numerous studies have examined the associations between dietary polyphenol subclasses (i.e. , flavonoids, phenolic acids, lignans, and stilbenes) and the risk of gastric cancer (GC), evidence regarding their relationships with gastric precancerous lesions (GPL) and their subtypes [i.e. , chronic atrophic gastritis, intestinal metaplasia (IM), and low-grade dysplasia (LGD)] remain…

BACKGROUND Gastric variceal hemorrhage (GVH) is among the most life-threatening complications of portal hypertension. Endoscopic variceal ligation (EVL) and cyanoacrylate injection (endoscopic variceal obturation) are the main endoscopic options for hemostasis, but their comparative efficacy and safety remain debated due to variable evidence. AIM To investigate the safety and efficacy of endoscop…

A recent study by Peng et al , published in the recent issue of World Journal of Gastroenterology , investigated the characteristics of peripheral blood lymphocyte subsets (PBLSs) and immune reconstitution patterns in patients with acute-on-chronic liver failure (ACLF) following liver transplantation. The findings revealed significant PBLS deficiencies in ACLF patients, with reduced natural kille…

BACKGROUND The concept of textbook oncologic outcome (TOO), serving as an integrated composite measure, has emerged to evaluate the overall standard of oncologic care. Its utilization now spans various cancer types, supported by growing evidence linking successful TOO achievement to improved long-term patient survival. However, the role of TOO in pancreatic cancer patients undergoing pancreaticod…

Gastric cancer arises within a complex and dynamic microenvironment shaped by gastric acid secretion, microbial communities, and chronic inflammation. While Helicobacter pylori (H. pylori ) remains the primary etiological factor, recent studies have highlighted the contribution of non-H. pylori microbiota and their interactions with host factors in the progression of gastric carcinogenesis. This …

This editorial comments on the study by Yang et al published in the recent issue of the World Journal of Gastroenterology , which investigates the mechanistic link between a high-fat diet (HFD), the gut microbial metabolite deoxycholic acid (DCA), macrophage polarization, and colonic inflammation, while evaluating the protective role of Bifidobacterium . Using a mouse model, the authors demonstra…

BACKGROUND Liver transplantation (LT) is traditionally contraindicated in patients with active extrahepatic metastases due to concerns regarding futility, donor risk, organ allocation fairness, and limited post-transplant survival. However, in rare and extreme situations, acute hepatic failure becomes immediately life-threatening and no alternative life-saving therapy exists. AIM To report two re…

This comment discusses the real-world study by Kritzinger et al , published in the recent issue of the World Journal of Gastroenterology , which reports preserved short-term clinical efficacy, stable biomarkers, and high treatment persistence after a mandatory non-medical switch from originator ustekinumab to a biosimilar in inflammatory bowel disease. While acknowledging the novelty and clinical…

BACKGROUND Acute kidney injury (AKI) is a common and serious complication of major abdominal surgery. However, predictive models specific to pancreatic surgery remain scarce. AIM To develop and validate an interpretable machine learning model for early prediction of postoperative AKI following pancreatic surgery. METHODS Adults undergoing pancreaticoduodenectomy or distal or total pancreatectomy …

BACKGROUND Real-world data remain limited on the effectiveness of magnesium isoglycyrrhizinate (MgIG) for post hepatectomy liver injury. We hypothesize that perioperative MgIG is effective as a management strategy against hepatic injury in patients undergoing hepatectomy. AIM To evaluate the prophylactic and therapeutic effectiveness of MgIG for hepatic injury in patients undergoing hepatectomy i…

Most patients with constipation do not require surgical treatment unless the cause of their symptoms is organic, such as entero-sigmoidocele or rectal intussusception. This review focuses on patients whose constipation is functional, such as slow-transit constipation or anismus. Selecting the appropriate treatment can be challenging in such cases, and surgery may worsen symptoms. This is because …

BACKGROUND Cytoplasmic calcium ions (Ca2+) are well-known intracellular signalling molecules, being involved in the integration of a variety of metabolic, proliferative and survival signals. They have been demonstrated an important role in embryonic and most adult stem cells (ASC). In the gut, it has been long recognized that Ca2+ handling is critical for the generation of pacemaker activity by C…

BACKGROUND Eosinophilic gastroenteritis (EGE) is a relatively rare disease characterized by eosinophilic infiltration of the gastrointestinal wall. Limited data are available regarding the clinical characteristics, treatment patterns, and outcomes of patients with EGE in Korea. AIM To investigate the clinical features, endoscopic findings, treatments, outcomes, and treatment response and relapse …

BACKGROUND Gastric subepithelial tumors (SETs), commonly encountered in gastrointestinal practice, require precise and complete resection to prevent recurrence and malignant transformation. AIM To compare efficacy, safety, and clinical outcomes between traction-preclosure (TPC)-assisted endoscopic full-thickness resection (EFTR) and conventional EFTR for gastric SETs. METHODS We retrospectively a…