Publications by authors named "Peter J Hegyi"
Article Synopsis
- The study compared three techniques for ERCP (endoscopic retrograde cholangiopancreatography) in patients who had undergone Roux-en-Y gastric bypass: enteroscopy-assisted (EA-ERCP), laparoscopy-assisted (LA-ERCP), and endoscopic ultrasound-directed (EDGE).
- 67 studies were analyzed, showing that EDGE had the highest technical success rate at 96%, followed by LA-ERCP at 93%, and EA-ERCP at 77%, with significant differences between EA-ERCP and the other methods.
- The overall rates of adverse events were similar across all techniques, suggesting that EDGE and LA-ERCP are both effective and as safe
Chronic liver diseases (CLD) affect 1.5 billion patients worldwide, with dramatically increasing incidence in recent decades. It has been hypothesized that the chronic hyperinflammation associated with CLD may increase the risk of a more severe course of acute pancreatitis (AP).
View Article and Find Full Text PDFBackground: Acute pancreatitis (AP) has a high incidence, and patients can develop recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) after AP.
Objectives: We aimed to estimate the pooled incidence rates (IRs), cumulative incidences, and proportions of RAP and CP after AP.
Design: A systematic review and meta-analysis of studies reporting the proportion of RAP and CP after AP.
Endoscopic Retrograde Cholangiopancreatography (ERCP) is the primary therapeutic procedure for pancreaticobiliary disorders, and studies highlighted the impact of papilla anatomy on its efficacy and safety. Our objective was to quantify the influence of papilla morphology on ERCP outcomes. We systematically searched three medical databases in September 2022, focusing on studies detailing the cannulation process or the rate of adverse events in the context of papilla morphology.
View Article and Find Full Text PDFThe risk of developing splanchnic vein thrombosis in acute pancreatitis increases 3 days after symptom onset: A systematic review and meta-analysis.
United European Gastroenterol J
July 2024
Background: Splanchnic vein thrombosis is a complication of acute pancreatitis (AP) and is likely often underdiagnosed.
Objectives: We aimed to understand the time course and risk factors of splanchnic vein thrombosis in the early phase of AP.
Methods: A systematic search was conducted using the PRISMA guidelines (PROSPERO registration CRD42022367578).
Article Synopsis
- There is a lack of discharge protocols for acute pancreatitis (AP) patients, which the Hungarian Pancreatic Study Group (HPSG) aims to address with a new, validated protocol based on laboratory data and symptoms.
- An international survey revealed that 87.5% of participating medical centers do not have discharge protocols, but those that do see shorter hospital stays and lower readmission rates.
- The HPSG discharge protocol resulted in the lowest average length of hospital stay and demonstrated safety through a low readmission rate, highlighting the need for developing and validating more standardized discharge protocols for AP care.
Low molecular weight heparin decreases mortality and major complication rates in moderately severe and severe acute pancreatitis-a systematic review and meta-analysis.
Front Med (Lausanne)
October 2023
Background: Routine anticoagulation therapy in acute pancreatitis (AP) is not recommended by the guidelines in the field, although it is frequently used in clinical practice.
Objectives: We aimed to analyze the efficacy and safety of adding anticoagulants therapy to AP management.
Methods: The systematic search was performed in three databases on the 14th of October 2022 without restrictions.
Aims: Ketosis-prone type 2 diabetes was defined by the World Health Organization in 2019. According to the literature, the diagnosis is based on the presence of ketosis, islet autoantibody negativity and preserved insulin secretion. Our meta-analysis assessed the prevalence and clinical characteristics of ketosis-prone type 2 diabetes among patients hospitalised with diabetic ketoacidosis (DKA) or ketosis.
View Article and Find Full Text PDFIntroduction: Only a small number of risk factors for pancreatic ductal adenocarcinoma (PDAC) has been established. Several studies identified a role of epigenetics and of deregulation of DNA methylation. DNA methylation is variable across a lifetime and in different tissues; nevertheless, its levels can be regulated by genetic variants like methylation quantitative trait loci (mQTLs), which can be used as a surrogate.
View Article and Find Full Text PDFArticle Synopsis
- Non-alcoholic fatty liver disease (NAFLD) has been redefined as metabolic-associated fatty liver disease (MAFLD), which is linked to an increased risk of acute pancreatitis (AP).
- In a study involving over 2,000 patients, 39% had MAFLD, which raised the odds of developing moderate-to-severe AP, although it didn't significantly impact in-hospital mortality.
- The severity of AP was influenced by the specific metabolic risk factors present, with a dose-dependent relationship observed—more criteria correlated with increased severity and outcomes for the disease.
Article Synopsis
- Acute pancreatitis (AP) is a serious inflammation of the pancreas, and identifying patients at high risk of severe complications early is essential to prevent organ failure and death.
- The study developed a machine learning prediction model called EASY, using data from over 4,700 patients to offer quick assessments of severity through algorithms like XGBoost, achieving an average accuracy of 89.1%.
- The model identifies key risk factors such as respiratory rate, body temperature, and glucose level, and includes a user-friendly web application for easy access to its predictions.
Article Synopsis
- Excessive alcohol consumption is a major cause of recurrent acute pancreatitis (AP), but effective treatments to prevent its recurrence, like psychological therapies, are not widely implemented in practice.
- A study analyzed 99 patients with alcohol-induced AP, where a 30-minute brief intervention (BI) by a physician led to significant reductions in alcohol consumption and related blood markers (GGT and MCV).
- After one month, 79% of patients reported being alcohol-free, indicating that BI could be a promising method to help prevent future cases of AP, though further research is needed to optimize its use.
Pancreatic necrosis is a consistent prognostic factor in acute pancreatitis (AP). However, the clinical scores currently in use are either too complicated or require data that are unavailable on admission or lack sufficient predictive value. We therefore aimed to develop a tool to aid in necrosis prediction.
View Article and Find Full Text PDFArticle Synopsis
- The rising incidence of acute pancreatitis (AP) has led to increased medical costs and a concerning 30% mortality rate in severe cases.
- A study involving 2461 patients revealed that hypoalbuminemia (low albumin levels) is common in AP, affecting 19% on admission and 35.7% during hospitalization.
- Severe hypoalbuminemia significantly increases the risk of complications and mortality, with a clear dose-dependent relationship to severity and hospital stay.
Background: Insulinoma is the most common neuroendocrine neoplasm of the pancreas, characterised by hypoglycaemic symptoms. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) and ethanol ablation (EUS-EA) are novel methods for treating insulinoma.We aimed to perform a systematic review to assess the efficacy and safety of EUS-guided ablation techniques for pancreatic insulinomas.
View Article and Find Full Text PDFHepatitis C virus (HCV)-infected patients treated with direct-acting antivirals (DAAs) are still at risk of developing hepatocellular carcinoma (HCC) after sustained virologic response (SVR). This study aimed to investigate the role of diabetes mellitus (DM) as a potential predictive risk factor in developing HCC in HCV-infected patients after DAA treatment. This study was registered on PROSPERO under registration number CRD42021230457.
View Article and Find Full Text PDFAcute pancreatitis (AP) is a life-threatening disease. We aimed to explore the prognostic relevance of renal function based on estimated glomerular filtration rate (eGFR). A prospective registry of AP patients was established by the Hungarian Pancreatic Study Group.
View Article and Find Full Text PDFObjectives: Post-ERCP pancreatitis (PEP) is a life-threatening complication. Given the lack of a causative treatment for pancreatitis, it is of vital importance to minimize this risk of PEP. Multi-target preventive therapy may be the best choice for PEP prevention as disease development is multifactorial.
View Article and Find Full Text PDFBackground: Pseudocysts being the most frequent local complications of acute pancreatitis (AP) have substantial effect on the disease course, hospitalization and quality of life of the patient. Our study aimed to understand the effects of pre-existing (OLD-P) and newly developed (NEW-P) pseudocysts on AP.
Methods: Data were extracted from the Acute Pancreatitis Registry organized by the Hungarian Pancreatic Study Group (HPSG).
Objective: The goal of treatment in ulcerative colitis (UC) is to induce and maintain remission. The addition of granulocyte and monocyte apheresis (GMA) to conventional therapy may be a promising therapeutic alternative. In this meta-analysis, we aimed to assess the efficacy and safety profile of GMA as an adjunctive therapy.
View Article and Find Full Text PDFThe most common pre-existing liver disease, the metabolic dysfunction-associated fatty liver disease (MAFLD) formerly named as non-alcoholic fatty liver disease (NAFLD), may have a negative impact on the severity of COVID-19. This meta-analysis aimed to evaluate if MAFLD or NAFLD are associated with a more severe disease course of COVID-19. A systematic search was performed in five databases for studies comparing severity, the rate of intensive care unit (ICU) admission, and mortality of COVID-19 patients with and without MAFLD or NAFLD.
View Article and Find Full Text PDFSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathogen of coronavirus disease 2019 (COVID-19), caused the outbreak escalated to pandemic. Reports suggested that near 1-3% of COVID-19 cases have a fatal outcome. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are widely used in hypertension, heart failure and chronic kidney disease.
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- Chronic pancreatitis (CP) is a severe condition with no specific treatment, making early diagnosis essential for better outcomes.
- A study analyzed data from both acute pancreatitis (AP) and chronic pancreatitis (CP) patients, revealing that experiencing three or more episodes of AP significantly increases the risk of developing CP.
- Findings suggest that patients with three or more recurrent AP episodes could be classified as having early chronic pancreatitis (ECP), allowing for earlier diagnosis without extra healthcare costs.
The rising prevalence of cirrhotic cases related to non-alcoholic steatohepatitis has led to an increased number of cirrhotic patients with coexistence of obesity and muscle mass loss, known as sarcopenic obesity (SO). In patients undergoing liver transplantation (LT), the presence of SO may worsen prognosis, and increase morbidity and mortality. We aimed to evaluate the effect of the presence of pre-transplant SO on the outcomes of LT.
View Article and Find Full Text PDFArticle Synopsis
- - The study conducted a systematic review and meta-analysis to assess how liver function tests and liver diseases at the time of admission impact the severity and outcomes of COVID-19, analyzing data from 50 studies registered on PROSPERO.
- - Key findings indicated that factors like acute liver failure, chronic liver disease, platelet counts, and liver enzyme levels (ALT, AST) were significant predictors for ICU admission, high severity cases, and in-hospital mortality rates in COVID-19 patients.
- - Overall, the research established that having pre-existing liver conditions or experiencing acute liver injury during COVID-19 significantly affects prognosis and can help in predicting patient outcomes.