BACKGROUND:The link between cholecystectomy and the risk of periampullary tumors (PTs) is uncertain. The purpose of this systematic review and meta-analysis was to examine the available evidence on this association. METHODS:A systematic literature search was conducted in PubMed, Embase, and Web of Science for relevant studies published between 1996 and 2024. We considered studies that reported relative risks (RRs) for PTs after cholecystectomy. The Newcastle-Ottawa Scale was used to assess the risk of bias. RESULTS:The analysis includes 5 studies (n=107,476). A forest plot of individual study RRs and 95% CIs showed significant variation in the outcomes. A meta-analysis of 5 studies found a statistically significant increase in the hazard rate (HR) of primary tumors (PTs) after cholecystectomy, with a pooled HR of 1.48 (95% CI: 1.14-1.93; P <0.05). However, there was significant heterogeneity (I²=69%, P =0.01175), indicating an elevated risk of PTs associated with cholecystectomy. CONCLUSIONS:The existing evidence on the link between cholecystectomy and PTs risk is equivocal; however, a pooled study implies an elevated risk. More research, particularly large-scale prospective studies with established methodologies, is needed to better understand this link and inform therapeutic decision-making.

Background:The use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has remarkably increased in the past few years as they have demonstrated significant reduction in A1c and major cardiovascular outcomes and have led to weight loss with low risk of hypoglycemia. GLP-1 RA use has raised concerns about potential associations with increased gastric retention and adverse outcomes in upper endoscopy procedures. Methods:We conducted a comprehensive search across multiple databases to identify comparative studies evaluating the impact of GLP-1 RA exposure versus non-exposure on upper endoscopy outcomes. Studies comparing GLP-1 RAs to other medications were excluded. The primary outcome was the presence of retained gastric contents, with secondary outcomes including aspiration risk and the need for repeated esophagogastroduodenoscopy (EGD). Results:Our systematic review included 28 studies, comprising data from 212,082 individuals collected between 2015 and 2023. The meta-analysis revealed that GLP-1 RA use was associated with approximately four times higher odds of retained gastric contents compared to non-exposure (odds ratio (OR): 3.95, confidence interval (CI): 2.691-5.815, P < 0.0001, I2: 82.71%). There were no increased odds of aspiration (OR: 1.09, CI: 0.459-2.600, P = 0.145, I2: 91.44%) or repeated upper endoscopies (OR: 1.82, CI: 0.813-4.085, P = 0.145, I2: 85.32%). However, GLP-1 RA use was significantly associated with increased odds of procedure cancellation (OR: 3.96, CI: 2.870-5.563, P < 0.0001, I2: 4.19%). Conclusion:While GLP-1 RAs do not increase the risk of aspiration or necessitate repeated procedures, they are linked to a higher incidence of retained gastric contents and procedure cancellations. Further randomized controlled trials are necessary to better understand the effects of GLP-1 RAs on upper endoscopy outcomes.

The link between cholecystectomy and the risk of periampullary tumors (PTs) is uncertain. The purpose of this systematic review and meta-analysis was to examine the available evidence on this association. A systematic literature search was conducted in PubMed, Embase, and Web of Science for relevant studies published between 1996 and 2024. We considered studies that reported relative risks (RRs) for PTs after cholecystectomy. The Newcastle-Ottawa Scale was used to assess the risk of bias. The analysis includes 5 studies (n=107,476). A forest plot of individual study RRs and 95% CIs showed significant variation in the outcomes. A meta-analysis of 5 studies found a statistically significant increase in the hazard rate (HR) of primary tumors (PTs) after cholecystectomy, with a pooled HR of 1.48 (95% CI: 1.14-1.93; P <0.05). However, there was significant heterogeneity (I²=69%, P =0.01175), indicating an elevated risk of PTs associated with cholecystectomy. The existing evidence on the link between cholecystectomy and PTs risk is equivocal; however, a pooled study implies an elevated risk. More research, particularly large-scale prospective studies with established methodologies, is needed to better understand this link and inform therapeutic decision-making.

Hypercalcemia is an identified complication of several malignancies and can cause significant adverse events. It is usually associated with cancers of the breast, lung (especially squamous cell), renal cell carcinoma, and multiple myeloma. Here, we present a rare case of esophageal adenocarcinoma presenting with hypercalcemia.

Gastroesophageal reflux disease (GERD) is a prevalent and chronic disorder impacting a significant proportion of the global population, approximately 15

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) are prevalent conditions linked to obesity and metabolic disturbances, with potential complications such as cirrhosis and cardiovascular risks. This systematic review and meta-analysis aimed to evaluate the efficacy of pemafibrate, a drug targeting fat and sugar metabolism genes, in treating patients with MASLD/MASH. Methods: Databases such as MEDLINE, Web of Science, Cochrane Library, and Scopus were searched until September 2023 to identify relevant studies. Selected studies underwent a thorough quality assessment using tools like Risk of Bias 2 tool (ROB-2) and the National Institutes of Health (NIH) Quality Assessment Tools. Comprehensive meta-analysis software was used for statistical evaluations, with a focus on lipid profiles, liver function tests, and fibrosis measurements. Results: A total of 13 studies were included; 10 of them were included in the quantitative analysis. Our findings showed that pemafibrate significantly decreased low-density lipoprotein cholesterol (LDL-C) (effect size (ES) =-9.61 mg/dL, 95% confidence interval (CI):-14.15 to-5.08), increased high-density lipoprotein cholesterol (HDL-C) (ES = 3.15 mg/dL, 95% CI: 1.53 to 4.78), and reduced triglycerides (TG) (ES =-85.98 mg/dL, 95% CI:-96.61 to-75.36). Additionally, pemafibrate showed a marked reduction in liver enzyme levels, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), and alkaline phosphatase (ALP), with significant effect sizes and P values. For liver stiffness outcomes, pemafibrate decreased AST to platelet ratio index (APRI) (ES =-0.180, 95% CI:-0.221 to-0.138). Conclusions: Pemafibrate, with its enhanced efficacy and safety profile, presents as a pivotal agent in MASLD/MASH treatment. Its lipid-regulating properties, coupled with its beneficial effects on liver inflammation markers, position it as a potentially invaluable therapeutic option.