Urgent endoscopic retrograde cholangiopancreatography with sphincterotomy versus conservative treatment in predicted severe acute gallstone pancreatitis (APEC): a multicentre randomised controlled trial

Randomised trial compared urgent ERCP with sphincterotomy versus conservative treatment. The primary endpoint was a composite of mortality or major complications within 6 months of randomisation. No relevant differences in the individual components of the primary endpoint were recorded between groups, apart from the occurrence of cholangitis. Findings support a conservative strategy in patients with predicted severe acute gallstone pancreatitis with an E RCP indicated only in patients who have c

A systematic review of symptomatic small bowel lipomas of the jejunum and ileum

Small bowel lipomas are rarely encountered benign adipose growths found within the small intestine wall or mesentery. We aim to aid clinical decision-making and improve patient outcomes. 124/137 (90.5%) required definitive surgical management. 9 patients were successfully managed endoscopically. Open surgery remains the primary management. Endoscopic and laparoscopic techniques may reduce utilising invasive surgery in the future as skillset and availability improve. 4 complications, 0 mortality.

Endoscopic Ultrasound-Guided, Percutaneous, and Transjugular Liver Biopsy: A Comparative Systematic Review and Meta-Analysis

Endoscopic ultrasound-guided liver biopsy (EUSLB) has become an attractive alternative. EUSLB appears to be a safe, minimally invasive procedure that is comparable to PCLB and TJLB regarding biopsy specimens obtained and rate of adverse events associated with each method. Compared to TJLB, EUS LB showed no difference in LLP( length of longest piece) (p=0.351), fewer CPT( complete portal triads), and longer TSL( total specimen length).

Systematic review with meta-analysis: age-related malignancy detection rates at upper gastrointestinal endoscopy

Age is an important and objective risk factor for upper gastrointestinal (GI) malignancy. The accuracy of various age limits to detect upper GI malignancies is unclear. Aim of this analysis was to synthesize data on upper GI malignancy detection rates. To detect >80% of malignant cases all symptomatic patients over 40 years of age should be investigated in Africa,over 50 years of age in South America and Asia, and over 55 years of age in North America and Europe.

Faecal microbiota transplantation for recurrent Clostridioides difficile infection: An updated systematic review and meta-analysis

Faecal microbiota transplantation (FMT) is effective for recurrent Clostridioides difficile infection (CDI) However, inconsistent effect rates and uncertain evidence levels have warranted caution. We aimed to establish the evidence of FMT for recurrent CDI across different delivery methods, treatment regimens, and in comparison with standard antibiotics. The overall clinical effect week 8 following repeat FMT (24 studies, 1855 patients) was 91% (95% CI: 89-94%, I 2=53%) and 84% (80-88%) followin

Primary obesity surgery endoluminal (POSE) for the treatment of obesity: a systematic review and meta-analysis

Primary obesity surgery endoluminal (posex) utilizes an incision-less operating platform system to create full-thickness plications in the gastric fundus and body. Many studies have demonstrated the safety and efficacy of original POSE for the treatment of obesity. The outcomes of POSE meet and surpass the ASGE joint task force thresholds. Future studies should evaluate newer versions of this procedure that emphasize gastric body plication sparing the fundus, authors say. The overall incidence o

Endoscopic ultrasound-guided parenchymal liver biopsy: a systematic review and meta-analysis

Endoscopic ultrasonography (EUS)-guided liver biopsy is a novel technique to obtain adequate liver samples for diagnosis of liver parenchymal diseases. The aim was to determine the diagnostic accuracy of EUS-LB and evaluate factors associated with specimen quality. We searched databases to identify studies in which results of E US-guided liver parechymic biopsies were reported published up to July 2020. Using FNB needles with a slow-pull technique can provide better results than fine-needle aspi

Endobronchial ultrasound-guided transbronchial needle aspiration combined with either endoscopic ultrasound-guided fine-needle aspiration or endoscopic ultrasound using the EBUS scope-guided fine-needle aspiration for diagnosing and staging mediastinal diseases: a systematic review and meta-analysis

Combining EBUS-TBNA with EUS-FNA was associated with slightly better diagnostic accuracy than combining it with Eus-B-Fna. Evidence suggests that the combination of EBus- TBNA with either EUS.FNA or EUS:FNA provides relatively high accuracy for diagnosing mediastinal diseases. The combination with E US-F NA may be slightly better, however, according to our analysis.