Background: Diabetes mellitus (DM) is a condition that may increase the severity of acute pancreatitis (AP) through chronic inflammation and disturbances in immune responses. However, the independent effect of DM on clinical outcomes in AP has not yet been fully elucidated. Methods: In this retrospective cohort study, 492 patients diagnosed with acute pancreatitis at the Gastroenterology Clinic of Ankara Bilkent City Hospital between January 2022 and March 2025 were included. Patients were divided into two groups based on the presence of diabetes, and outcomes were compared using statistical methods. Results: Of the total 492 patients (mean age 58.6 ± 17.2 years; 50.2% female) included, 98 (19.9%) had DM. Moderate-to-severe AP occurred in 67.3% of diabetic versus 37.8% of non-diabetic patients (p < 0.0001), and severe disease developed more frequently in the diabetic group (6.1% vs. 1.0%, p = 0.0057). Systemic complications were significantly more common in patients with diabetes (45.9% vs. 26.9%, p = 0.0004). Hospital mortality was higher among patients with diabetes (9.2% vs. 4.6%, p = 0.0344), and Kaplan–Meier analysis demonstrated numerically lower overall survival in patients with diabetes (log-rank p = 0.095), with early divergence in survival curves. Cox proportional hazards analysis confirmed diabetes as an independent predictor of in-hospital mortality (adjusted HR 2.64, 95% CI 1.17–5.97; p = 0.019). After adjustment for confounders, diabetes remained independently associated with the development of moderate/severe pancreatitis (adjusted OR 2.00, 95% CI 1.24–3.22; p = 0.004). Diabetes also independently predicted in-hospital mortality (adjusted OR 3.36, 95% CI 1.35–8.34; p = 0.009), along with APACHE II score. ROC analysis demonstrated that adding diabetes mellitus to the APACHE II score significantly improved mortality prediction compared with APACHE II alone (AUC 0.785 vs. 0.724). The retrospective and single-center design of this study may limit its generalizability and create potential selection bias. There were insufficient data on the type of diabetes, its duration, and glycemic control (e.g., HbA1c), and therefore, we could not assess these factors, all of which may influence risk estimates. Although the survival curves showed early divergence, the borderline log-rank significance (p = 0.095) highlights the limited statistical power to detect long-term survival differences in this cohort. Conclusions: DM is associated with substantially increased severity and in-hospital mortality in AP, primarily through an elevated risk of systemic organ failure. Incorporation of diabetes status into early severity stratification may improve prognostic accuracy and guide closer monitoring and timely interventions in this high-risk population.

Background: Common bile duct (CBD) stones may pass spontaneously without any intervention. Assessment of the predictors of spontaneous passage can contribute to avoiding unnecessary endoscopic retrograde cholangiopancreatography (ERCP) implementation. This study aimed to investigate the factors related to spontaneous passage of CBD stones. Methods: From January 2021 to August 2023, patients with naïve papilla who had undergone biliary ERCP and with CBD stones detected by MRCP before the procedure were analyzed retrospectively. Subjects were divided into two groups on the basis of the presence of stones during the ERCP procedure: the spontaneous passage group and the non-passage group. Groups were compared in terms of demographic, laboratory, and radiological data. Results: A total of 236 patients, including 26 in the spontaneous passage group and 210 in the non-passage group, were involved. Multivariate logistic regression analyses revealed that only stone size was significantly associated with spontaneous passage. From ROC curve analysis, stone size with a cut-off value of 4.3 mm predicted spontaneous passage with 58% sensitivity and 85% specificity. Conclusions: Stones with a size of less than 4.3 mm are more likely to pass spontaneously without endoscopic intervention. Paying attention to the stone diameter before ERCP procedures can contribute to avoiding unnecessary ERCP implementation.

Background/Aims: Obesity is a growing global health challenge associated with increased morbidity and mortality. Intragastric balloon therapy has emerged as a minimally invasive alternative for weight management in patients unsuitable for bariatric surgery or as a bridging intervention. This study evaluates the efficacy, safety, and metabolic impacts of intragastric balloon therapy in a prospective cohort. Materials and Methods: A total of 65 patients underwent endoscopic intragastric balloon therapy between October 2023 and January 2025. Comprehensive baseline evaluations included body weight, body mass index, and computed tomography analysis of visceral and subcutaneous fat tissue thickness. Patients were followed up at 2 and 6 months post procedure. Statistical analysis was performed to assess weight loss, metabolic changes, and safety outcomes. Results: Of the initial cohort, 62 patients (mean age: 37.89 years; 75.4% female) completed the study. The median body weight decreased significantly from 104.5 kg pre procedure to 88 kg at 6 months (P < .001). Body mass index values similarly declined, with a mean reduction from 37.59 to 32.79 kg/m2 (P < .001). Significant decreases in subcutaneous and visceral fat tissue thickness were observed (P < .001 and P = .032, respectively). Only 1 patient (1.5%) required early balloon removal due to nausea, with no other major complications reported. Conclusion: Intragastric balloon therapy is an effective and safe intervention for short term weight loss, with significant reductions in adipose tissue. Further research is needed to evaluate its long-term efficacy and metabolic benefits. Cite this article as: Yüksel M, Kenarlı K, Sarıaltın F, et al. Six-month outcomes of endoscopic intragastric balloon therapy: A prospective single-center study. Turk J Gastroenterol. 2025;36(11):770-775.

Giriş ve Amaç: Obezite dünya çapında giderek yaygınlaşmaktadır. Son yıllarda obezite tedavisinde pek çok gelişme yaşansa da endoskopik tedavi yöntemleri, davranışsal tedavilere göre yan etkilerinin düşük olması ve başarı oranının daha yüksek olması nedeniyle önemli bir yere sahiptir. İntragastrik Botulinum toksin enjeksiyonu ile ilgili yapılan çalışmalarda kafa karıştırıcı sonuçlar olmasına rağmen bunun sebebi hala açıklığa kavuşturulamamıştır. Bu çalışmadaki amacımız Helicobacter pylori enfeksiyonunun intragastrik Botulinum toksin enjeksiyon tedavisi başarısı üzerindeki etkilerini değerlendirmektir. Gereç ve Yöntem: On sekiz ile 65 yaşları arasında, vücut kitle indeksi 25 kg/m2'nin üzerinde ve en az bir obezite ile ilişkili komplikasyonu olan veya komplikasyon olmadan vücut kitle indeksi 30 kg/m2'den fazla olan 80 hasta çalışmaya dahil edildi. Helicobacter pylori değerlendirmesi için intragastrik Botulinum toksini uygulaması esnasında mide antrumundan biyopsiler alındı ve hastalar Helicobacter pylori pozitifliği veya negatifliğine göre iki gruba ayrıldı. Bulgular: Çalışmamızda her iki grupta da başlangıç kilolarına göre istatistiksel olarak anlamlı azalma görüldü (p < 0.001). Ancak mide mukozasında Helicobacter pylori varlığı veya yoğunluğunun kilo kaybı üzerinde istatistiksel olarak anlamlı bir etkisi yoktu. Sonuç: İntragastrik Botulinum toksini uygulamasında çelişkili sonuçlara neden olabilecek durumlardan biri olan Helicobacter pylori enfeksiyonunun kilo kaybına etkisinin olmadığı gösterilmiştir.