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Introduction

This study aims to determine whether endoscopic papillectomy (EP) is a safe and effective treatment for early duodenal papillary carcinoma with long-term follow-up.

Aims & Methods

From June 2012 to September 2021, 48 patients with early duodenal papilloma carcinoma who received endoscopic treatment at Hangzhou First People's Hospital were included. The histological types, percentage of complete resections, postoperative residuals, adverse events, and recurrences were evaluated.

Results

Endoscopic papillectomy (EP) was successful in all patients, 46 were lumped, and two were fragmented, with a 95.8% intact removal rate (46/48). Postoperative pathology indicated 24 cases of high-grade intraepithelial neoplasia, 9 cases of moderately differentiated adenocarcinoma, and 15 cases of highly differentiated adenocarcinoma. The preoperative biopsy pathological positive rate was 70.8% (34/48). Early postoperative adverse events (within one month after EP) were 16.7% (8/48), including 4 cases of acute pancreatitis, 3 cases of delayed bleeding, and 1 case of acute cholangitis. In addition, 4.2% (2/48) of late adverse events were bile duct stenosis. The postoperative residual rate was 0%. The median time to recurrence was 17.5 months, and the postoperative recurrence rate was 16.7% (8/48) treated with radiofrequency ablation. Median progression-free survival was 18.6 months (95%CI, 12.1 to 25.1), and median overall survival was 121.5 months (95%CI, 105.6 to 120.9).

Conclusion

Endoscopic papillectomy is a safe and efficient alternative therapy for early duodenal papillary carcinoma. Endoscopic follow-up and treatment are essential because of recurrence.

ENDOSCOPIC TREATMENT FOR EARLY DUODENAL PAPILLARY CARCINOMA: LONG-TERM OUTCOMES

Jianfeng Yang 1, Hayat Khizar 1

1 Hangzhou First People Hospital, Hangzhou, China

Conference

UEG Week Copenhagen 2023

Topics

Oesophagus

Submission format

Abstract

Session

PP 01 Oesophageal, gastric and duodenal disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

UEG Podcast Episode

UEG Podcast

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From Vienna to Berlin: What inspired us last year at UEG Week

Egle Dieninyte - Misiune, Pradeep Mundre

Published

2025

UEG Standards and Guidelines

Clinical Practice Guideline

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Abstract

Background

Variation exists in practice pertaining to bowel preparation before minimally invasive colorectal surgery. A survey of EAES members prioritized this topic to be addressed by a clinical practice guideline.

Objective

The aim of the study was to develop evidence-informed clinical practice recommendations on the use of bowel preparation before minimally invasive colorectal surgery, through evidence synthesis and a structured evidence-to-decision framework by an interdisciplinary panel of stakeholders.

Methods

This is a collaborative project of EAES, SAGES, and ESCP. We updated a previous systematic review and performed a network meta-analysis of interventions. We appraised the certainty of the evidence for each comparison, using the GRADE and CINeMA methods. A panel of general and colorectal surgeons, infectious diseases specialists, an anesthetist, and a patient representative discussed the evidence in the context of benefits and harms, the certainty of the evidence, acceptability, feasibility, equity, cost, and use of resources, moderated by a GIN-certified master guideline developer and chair. We developed the recommendations in a consensus meeting, followed by a modified Delphi survey.

Results

The panel suggests either oral antibiotics alone prior to minimally invasive right colon resection or mechanical bowel preparation (MBP) plus oral antibiotics; MBP plus oral antibiotics prior to minimally invasive left colon and sigmoid resection, and prior to minimally invasive right colon resection when there is an intention to perform intracorporeal anastomosis; and MBP plus oral antibiotics plus enema prior to minimally invasive rectal surgery (conditional recommendations); and recommends MBP plus oral antibiotics prior to minimally invasive colorectal surgery, when there is an intention to localize the lesion intraoperatively (strong recommendation). The full guideline with user-friendly decision aids is available in https://app.magicapp.org/#/guideline/LwvKej.

Conclusion

This guideline provides recommendations on bowel preparation prior to minimally invasive colorectal surgery for different procedures, using highest methodological standards, through a structured framework informed by key stakeholders.

Guideline registration number PREPARE-2023CN045.

Keywords: Bowel preparation, Colorectal surgery, Minimally invasive surgery, Laparoscopic surgery, Guidelines

EAES, SAGES, and ESCP rapid guideline: bowel preparation for minimally invasive colorectal resection

Stavros A. Antoniou

Publisher

European Association for Endoscopic Surgery and other interventional techniques

Guideline

Clinical Practice Guideline

Topics

Digestive Oncology Surgery

Citation

Surg Endosc 37, 9001–9012 (2023)

Published

2023

UEG Podcast Episode

Journal Podcast

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UEGJ Best Paper Award: Work productivity in DGBIs

Åsa Frändemark, Ahsen Ustaoglu, Haluk Tarik Kani

Published

2024

UEG Standards and Guidelines

Clinical Practice Guideline

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Abstract

Background: Evidence and practice recommendations on the use of transanal total mesorectal excision (TaTME) for rectal cancer are conflicting.

Objective: We aimed to summarize best evidence and develop a rapid guideline using transparent, trustworthy, and standardized methodology.

Methods: We developed a rapid guideline in accordance with GRADE, G-I-N, and AGREE II standards. The steering group consisted of general surgeons, members of the EAES Research Committee/Guidelines Subcommittee with expertise and experience in guideline development, advanced medical statistics and evidence synthesis, biostatisticians, and a guideline methodologist. The guideline panel consisted of four general surgeons practicing colorectal surgery, a radiologist with expertise in rectal cancer, a radiation oncologist, a pathologist, and a patient representative. We conducted a systematic review and the results of evidence synthesis by means of meta-analyses were summarized in evidence tables. Recommendations were authored and published through an online authoring and publication platform (MAGICapp), with the guideline panel making use of an evidence-to-decision framework and a Delphi process to arrive at consensus.

Results: This rapid guideline provides a weak recommendation for the use of TaTME over laparoscopic or robotic TME for low rectal cancer when expertise is available. Furthermore, it details evidence gaps to be addressed by future research and discusses policy considerations. The guideline, with recommendations, evidence summaries, and decision aids in user-friendly formats can also be accessed in MAGICapp: https://app.magicapp.org/#/guideline/4494.

Conclusions: This rapid guideline provides evidence-informed trustworthy recommendations on the use of TaTME for rectal cancer.

Keywords: Rectal cancer · TaTME · Transanal TME · Clinical practice guideline · GRADE · EAES

Additional resource: https://app.magicapp.org/#/guideline/LGm87E

UEG and EAES rapid guideline: Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer

Marco Milone

Publisher

European Association for Endoscopic Surgery and other interventional techniques

Guideline

Clinical Practice Guideline

Topics

Digestive Oncology Surgery

Citation

Surgical Endoscopy volume 36, pages2221–2232 (2022)

Published

2021

UEG Standards and Guidelines

Clinical Practice Guideline

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Abstract

Introduction

Microscopic colitis is a chronic inflammatory bowel disease characterised by normal or almost normal endoscopic appearance of the colon, chronic watery, nonbloody diarrhoea and distinct histological abnormalities, which identify three histological subtypes, the collagenous colitis, the lymphocytic colitis and the incomplete microscopic colitis. With ongoing uncertainties and new developments in the clinical management of microscopic colitis, there is a need for evidence-based guidelines to improve the medical care of patients suffering from this disorder.

Methods

Guidelines were developed by members from the European Microscopic Colitis Group and United European Gastroenterology in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument. Following a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the certainty of the evidence. Statements and recommendations were developed by working groups consisting of gastroenterologists, pathologists and basic scientists, and voted upon using the Delphi method.

Results

These guidelines provide information on epidemiology and risk factors of microscopic colitis, as well as evidence-based statements and recommendations on diagnostic criteria and treatment options, including oral budesonide, bile acid binders, immunomodulators and biologics. Recommendations on the clinical management of microscopic colitis are provided based on evidence, expert opinion and best clinical practice.

Conclusion

These guidelines may support clinicians worldwide to improve the clinical management of patients with microscopic colitis.

Keywords: budesonide, diarrhoea, inflammatory bowel disease, microscopic colitis

European Guideline on Microscopic colitis - UEG and EMCG consensus recommendations

Stephan Miehlke

Guideline

Clinical Practice Guideline

Topics

Histopathology IBD Immunology

Citation

United European Gastroenterol J.2021;9:13–37

Published

2021

UEG Standards and Guidelines

Clinical Practice Guideline

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Summary

Vascular diseases of the liver include portal vein thrombosis (with or without cirrhosis), portosinusoidal vascular disorder, Budd-Chiari syndrome, sinusoidal obstruction syndrome, non-obstructive sinusoidal dilatation and peliosis, splanchnic artery aneurysms, and hepatic arteriovenous fistulas. Except for portal vein thrombosis in cirrhosis, these are all rare conditions. Since the last Clinical Practice Guidelines were issued by the European Association for the Study of the Liver in 2016, much data has been published on the diagnosis and management – medical and interventional – of patients with vascular liver diseases. Based on a thorough review of the relevant literature, recommendations are provided to address key clinical dilemmas. The document emphasises personalised care, considering individual risk factors and clinical presentation. Multidisciplinary management involving hepatologists, haematologists, pathologists, interventional radiologists and surgeons is essential in this area. Our aim is to provide guidance on the management of patients with vascular liver diseases based on the best available evidence.

EASL Clinical Practice Guidelines on vascular diseases of the liver

Publisher

European Association for the Study of the Liver

Guideline

Clinical Practice Guideline

Topics

Hepatobiliary

Citation

Journal of Hepatology; Volume 84, Issue 2, 399-456

Published

2025

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