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Special Issue "Diagnosis and Management in Digestive Surgery"

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Guest Editor

Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Interests: surgical oncology; laparoscopic surgery; colorectal surgery

Dr. Florin Grama

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Guest Editor

Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Interests: surgical oncology; laparoscopic surgery; colorectal surgery

Special Issue Information

Dear Colleagues,

This Special Issue is intended to serve as an opportunity to provide an update in terms of the diagnosis and management of digestive diseases. We have all witnessed to some extent the technical and technological development within the medical field. Nevertheless, due to rapid changes, self-actualization can be occasionally strenuous. The methods of diagnosis but also management have undergone serious modifications with the passage of time, hence the utility of this Special Issue. Whether we are talking about improved precision when determining the type of pathology or tailored multidisciplinary treatment, the field of digestive diseases is in constant change. Interesting diagnoses or fascinating management techniques can be submitted as an article for publication. Research articles, review articles, and special case reports are invited.

Dr. Valentin Calu
Dr. Florin Grama
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

digestive diseases
novel changes in diagnosis
updates on daily practice
management of digestive diseases

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Research

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Open AccessArticle

The Accuracy of Point-of-Care Ultrasound (POCUS) in Acute Gallbladder Disease

Bogdan-Daniel Dumbrava

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Diagnostics 2023, 13(7), 1248; https://doi.org/10.3390/diagnostics13071248 - 26 Mar 2023

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Abstract

There is increasing recognition that point-of-care ultrasound (POCUS), performed by the clinician at the bedside, can be a natural extension of the clinical examination—the modern abdominal “stethoscope” and provides an opportunity to expedite the care pathway for patients with acute gallbladder disease. The primary aims of this study were to benchmark the accuracy of surgeon-performed POCUS in suspected acute gallbladder disease against standard radiology or pathology reports and to compare time to POCUS diagnosis with time to definitive imaging. This prospective single-arm observational cohort study was conducted in four hospitals in Ireland, Italy, and Portugal to assess the accuracy of POCUS against standard radiology in patients with suspected acute biliary disease (ClinicalTrials.govIdentifier: NCT02682368). The findings of surgeon-performed POCUS were compared with those on definitive imaging or surgery. Of 100 patients recruited, 89 were suitable for comparative analysis, comparing POCUS with radiological findings in 84 patients and with surgical/histological findings in five. The overall global accuracy of POCUS was 88.7% (95% CI, 80.3–94.4%), with a sensitivity of 94.7% (95% CI, 85.3–98.9%), a specificity of 78.1% (95% CI, 60.03–90.7%), a positive likelihood ratio (LR+) of 4.33 and negative likelihood ratio (LR) of 0.07. The mean time from POCUS to the final radiological report was 11.9 h (range 0.06–54.9). In five patients admitted directly to surgery, the mean time between POCUS and incision was 2.30 h (range 1.5–5), which was significantly shorter than the mean time to formal radiology report. Sixteen patients were discharged from the emergency department, of whom nine did not need follow-up. Our study is one of the very few to demonstrate a high concordance between surgeon-performed POCUS of patients without a priori radiologic diagnosis of gallstone disease and shows that the expedited diagnosis afforded by POCUS can be reliably leveraged to deliver earlier definitive care for patients with acute gallbladder pathology, as the general surgeon skilled in POCUS is uniquely positioned to integrate it into their bedside assessment. Full article

(This article belongs to the Special Issue Diagnosis and Management in Digestive Surgery)

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Nonalcoholic Fatty Liver Disease-Related Hepatocellular Carcinoma: The Next Threat after Viral Hepatitis

Louis Lau

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Diagnostics 2023, 13(16), 2631; https://doi.org/10.3390/diagnostics13162631 - 09 Aug 2023

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Abstract

For many years, we have faced the complications of viral hepatitis and alcohol-related liver diseases such as cirrhosis, decompensation, portal hypertension, and hepatocellular carcinoma (HCC). Recently, we have seen a dynamic change in the field of hepatology. With the significant achievements in eradicating the hepatitis C virus by direct-acting antiviral agents and the rising epidemic of obesity, diabetes mellitus, and metabolic syndrome, there is a paradigm shift in the leading cause of liver cirrhosis and cancer to nonalcoholic fatty liver disease (NAFLD). Current data highlight the rapidly rising incidence of NAFLD-related HCC worldwide and expose the unseen part of the iceberg. In this review, we aim to update knowledge about the pathogenesis of NAFLD-induced HCC, surveillance difficulties, and promising disease markers. Molecular biomarkers, for example, may become a promising cornerstone for risk-stratified surveillance, early detection, and treatment selection for NAFLD-related HCC. Physicians can offer personalized and tailor-made clinical decisions for this unique patient subgroup. Full article

(This article belongs to the Special Issue Diagnosis and Management in Digestive Surgery)

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Special Issue "Diagnosis and Management in Digestive Surgery"

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