Autoimmune pancreatitis (AIP) is a rare chronic form of pancreatitis mediated by autoimmune mechanisms. Evidence regarding the diagnostic performance of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) in AIP remains limited. This study aimed to estimate the pooled diagnostic accuracy of EUS-FNB in patients with AIP.

Inflammatory markers are routinely used in the evaluation of inflammatory bowel disease (IBD). Red blood cell distribution width (RDW) has previously been proposed as a potential biomarker in the evaluation of IBD. This meta-analysis and systematic review challenges the utility of RDW in IBD evaluation.

Serotonin (5-hydroxytryptamine [5-HT]) is a key regulator of gastrointestinal function and exerts its effects through a diversity of 5-HT receptors. In the gut, 5-HT is released primarily by enterochromaffin cells, which act as specialized epithelial chemo- and mechanosensors. In humans, 5-HT modulates gastric sensorimotor function, and animal studies suggest that it is involved in enteric neurogenesis. Altered serotonergic signaling is increasingly recognized as an important contributor to the pathophysiology of gastric motility disorders and, therefore, represents an important therapeutic target. Although early serotonergic agents such as cisapride were withdrawn due to safety concerns, newer receptor-specific ligands have become available, broadening the therapeutic landscape and underscoring the need for an updated synthesis of serotonergic pathways and therapies in gastric motility disorders. For the management of gastroparesis, 5-HT4 agonists are the most consistently supported serotonergic agents in international guidelines, with evidence for improving gastric emptying and symptoms, and 5-HT3 antagonists are used primarily for symptomatic control of nausea and vomiting. In functional dyspepsia, serotonergic therapies may be selectively considered for off-label use based on the symptom profile, including mirtazapine (a 5-HT2 antagonist) in patients with early satiety and weight loss, and buspirone (a 5-HT1A agonist) in those with early satiety, postprandial fullness, or bloating. Although selective serotonin reuptake inhibitors and serotonin-noradrenaline reuptake inhibitors are not recommended for use in gastroparesis or functional dyspepsia, their potential role warrants further investigation, particularly given their established efficacy in conditions with chronic pain. Large, controlled trials evaluating the efficacy of serotonergic agents in gastroparesis and functional dyspepsia remain lacking, but recent developments highlight the continued relevance of serotonergic modulation. Recent data on naronapride, a newer 5-HT4 agonist, suggest that more selective agents may offer a clinically relevant benefit, while mitigating cardiovascular safety risks associated with earlier agents. By integrating molecular, physiological, and clinical data, this review aims to clarify the relevance of serotonergic signaling in gastric physiology and motility disorders, define its therapeutic applications, and identify the key remaining evidence gaps.

Metabolically-dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and is strongly influenced by genetic susceptibility. Among the identified genetic variants, the patatin-like phospholipase domain-containing protein 3 (PNPLA3) rs738409 (I148M) polymorphism has been consistently associated with hepatic steatosis and disease progression. However, previous meta-analyses included fewer studies, limited ethnic diversity, and insufficient investigation of between-study heterogeneity. This study aimed to comprehensively evaluate the association between the PNPLA3 rs738409 polymorphism and MASLD susceptibility.

Evidence for ustekinumab (UST) in pediatric inflammatory bowel disease (IBD) is limited, particularly in patients who do not respond to anti-tumor necrosis factor (anti-TNF) therapy. We conducted a meta-analysis to evaluate the efficacy and safety of UST in pediatric IBD after anti-TNF failure.

Hepatocellular carcinoma (HCC) is a leading indication for liver transplantation (LT), but post-transplant recurrence remains a major cause of treatment failure. Ischemia-reperfusion injury (IRI) has been implicated in tumor recurrence through modulation of the hepatic microenvironment. Machine perfusion (MP) techniques reduce IRI and may improve oncologic outcomes. This systematic review and meta-analysis evaluated the impact of MP versus static cold storage (SCS) on HCC recurrence following LT.

Sessile serrated lesions (SSLs) of the appendix remain a controversial entity due to evolving definitions, diagnostic criteria, and nomenclature. Shifts in diagnostic thresholds - from multiple serrated crypts to a single unequivocally serrated and distorted crypt - have led to discrepancies in lesion classification and retrospective analyses. These controversies, compounded by inconsistent adherence to updated criteria, highlight the need for studies and reviews applying contemporary standards to accurately assess incidence and clinical significance.

Endoscopic retrograde cholangiopancreatography (ERCP) is increasingly used in children with pancreatobiliary disease, but pediatric adverse-event estimates remain variable. We updated the evidence on post-ERCP adverse events in children, pooled post-ERCP pancreatitis (PEP) incidence when study-level data allowed, and summarized reported risk factors and prevention strategies.

To explore the correlation between gut microbiota dysbiosis and the pathogenesis of ulcerative colitis (UC), and to provide an evidence-based basis for clinical diagnosis and treatment.

Patients with functional esophageal disorders exhibit symptoms such as chest pain, heartburn, dysphagia, globus sensation, or reflux hypersensitivity in the absence of structural abnormalities. This is characterized by dysregulated gut-brain interactions and visceral hypersensitivity.

Cholangiocarcinomas (CCAs) are cancers that arise in the peripheral or central bile ducts. They have substantial heterogeneity in their etiologies and histopathologic phenotypes, ranging from cholangiolar carcinomas arising from the smallest bile ducts or from dedifferentiating hepatocytes through cellular plasticity, to ductular cancers in medium and large-sized bile ducts. The surgical delineation of intrahepatic, perihilar, and distal CCAs does not match the biological classification, as intrahepatic CCAs include both small duct cholangiolar carcinoma and intermediate duct ductular or mucinous CCAs, which have different genomic and genetic characteristics. Despite their overall poor prognosis, CCAs have proven to include the most actionable target-rich types of cancer, with intrahepatic CCAs including relatively high percentages of fibroblast growth factor receptor 2 fusions and isocitrate dehydrogenase 1 or 2 mutations, as well as other currently or potentially targetable aberrations. We discuss the etiologies and risk factors for CCAs, review the pathophysiologic basis for tumor molecular heterogeneity in CCA, and discuss the known links with mutational signatures in subgroups of CCA, such as oxidative stress, aging, and exogenous exposures. The potential roles of differences in cell type-specific replication timing and immunoselective and metabolic pressures are discussed, as are the implications of synergistic or antagonistic oncogenic effects, leading to unique patterns of co-occurrence vs mutual exclusivity of alterations. In addition, we review the impacts of common genetic variants and known pathogenic germline or somatic variants that predispose carriers to CCA. Finally, we discuss the role of epigenetics and variations in DNA methylation in heterogeneity of CCA within the context of evolving treatment options and remaining key gaps in knowledge.

In patients with malignant biliary obstruction (MBO) where endoscopic retrograde cholangiopancreatography (ERCP) fails, endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is an important rescue option. This study compared the safety and efficacy of EUS-HGS alone versus EUS-HGS with antegrade stenting (EUS-HGAS).

This study examines how mercury (Hg) levels may be linked to colorectal cancer (CRC) by reviewing and analyzing existing research. It is important to understand this connection because mercury may cause cancer.

Celiac disease is an autoimmune disease rarely presenting as intestinal intussusception in less than 1% of all cases.

Decompensated cirrhosis has different causes. These causes differ in how they damage the liver, how difficult they are to treat, and how well they can be controlled. This may lead to different prevalences of recompensation. However, existing studies have failed to elucidate the heterogeneity of recompensation across different etiologies. Therefore, this study aimed to summarize differences in recompensation prevalence among decompensated cirrhosis etiologies according to the Baveno VII consensus, and to analyze the predictors and prognosis of recompensation.

Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, largely due to late diagnosis and the limited sensitivity of current screening biomarkers such as alpha-fetoprotein (AFP). Circulating long noncoding RNAs (lncRNAs) have recently emerged as promising, noninvasive biomarkers that may reflect the molecular mechanisms underlying hepatocarcinogenesis. This systematic review and meta-analysis aimed to comprehensively evaluate the diagnostic accuracy of circulating lncRNAs for detecting HCC.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide and is linked to dyslipidemia and cardiometabolic dysfunction. The non-HDL cholesterol to HDL cholesterol ratio (NHHR) has emerged as a composite lipid biomarker that reflects the balance between atherogenic and anti-atherogenic lipoproteins and may have utility in MASLD risk stratification. However, the strength and consistency of the association between NHHR and MASLD remain uncertain. This systematic review and meta-analysis aimed to synthesize the available evidence regarding the association between NHHR and MASLD and evaluate its diagnostic performance.

Liver cirrhosis is a leading cause of global liver-related morbidity and mortality, with hepatocellular carcinoma (HCC) being the most common and fatal complication. Transjugular intrahepatic portosystemic shunt (TIPS) is a minimally invasive treatment for ascites and gastrointestinal bleeding in patients with cirrhosis. Whether transjugular intrahepatic portalsystemic shunt (TIPS) increases the incidence of hepatocellular carcinoma (HCC) in patients with cirrhosis remains controversial. This study aimed to explore the association between TIPS and the development of HCC.

Chronic hepatitis B (CHB) affects nearly 300 million people worldwide and is a leading cause of hepatocellular carcinoma (HCC). While cirrhosis is a risk factor for HCC, hepatitis B virus (HBV) DNA integration can lead to HCC in non-cirrhotic individuals. This study synthesized existing data to compare HCC risk among non-cirrhotic patients treated with antivirals versus those untreated.

Endoscopic submucosal dissection (ESD) is an effective minimally invasive treatment for superficial gastric tumors. However, it is technically demanding and often associated with prolonged procedure time and a risk of adverse events. Traction-assisted ESD (TA-ESD) has been introduced to improve submucosal visualization and procedural efficiency; however, evidence regarding its benefit over conventional ESD (C-ESD) in gastric lesions remains inconsistent. This study aimed to compare procedural efficiency, resection quality, and safety between TA-ESD and C-ESD in patients with superficial gastric tumors.