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ROLE OF PROPHYLACTIC BILIARY STENT IN REDUCING RECURRENCE OF STONES AND BILIARY COMPLICATIONS AFTER STONE CLEARANCE IN PATIENTS AWAITING CHOLECYSTECTOMY-A RANDOMIZED CONTROLLED TRIAL

Arpit Sasani 1, Harshal Mandavdhare 1, Vishal Sharma 1, Jimil Shah 1, Amol Patil 1, Pankaj Gupta 1, Jayanta Samanta 1, Harjeet Singh 1, Usha Dutta 1

Affiliations

1 Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India

Summary

AI Generated

A randomized controlled trial found no advantage of prophylactic biliary stenting versus no stenting in preventing common bile duct stone recurrence or biliary complications in patients awaiting cholecystectomy after endoscopic stone clearance.

In 66 patients randomized after documented bile duct clearance, recurrence of common bile duct stones at three months was 20.59 percent in the stent group versus 9.38 percent in the no-stent group, a difference that was not statistically significant.
No patients in either group required emergency endoscopic retrograde cholangiography during follow-up, and biliary complications were infrequent in both arms.
Three patients in the stent group developed post-ERC pancreatitis compared to none in the no-stent group, though this difference did not reach statistical significance.
The authors acknowledge limitations including single-center design, possible underpowering, observer-dependent clearance assessment, and shorter recurrence assessment window compared to some prior studies.
This evidence may inform decisions about biliary stent placement after endoscopic stone clearance in patients with concomitant gallstones awaiting surgery.

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Abstract

Introduction

The role of prophylactic biliary stenting after clearance of common bile duct stones (CBDS) in patients awaiting cholecystectomy for concomitant gallstones is controversial.

Aims & Methods

Aim: To study the effect of prophylactic biliary stenting after achieving biliary clearance in reducing CBDS recurrence and biliary complications in patients awaiting cholecystectomy.
Methods: Patients with concomitant gallstones and CBDS were included and those who had evidence of clearance of CBDS that was documented on occlusion cholangiogram during endoscopic retrograde cholangiography (ERC) were randomized to prophylactic biliary stenting (group A) or no stenting (group B). After clearance, the patients were advised to undergo cholecystectomy as early as possible. The patients were followed up at 1 week, 1, 2, and 3 months after clearance, and at 3 months or after cholecystectomy (whichever was early) they were assessed for recurrence of CBDS by either endoscopic ultrasound or MRCP or ultrasound abdomen and liver function test whichever was convenient for the patient. During each follow-up visit patients were assessed for symptoms and were requested to do a hemogram and liver function test. The primary outcome was to compare the CBDS recurrence rate, while the secondary outcomes were to compare the biliary complications and the need for repeat/ emergency ERC. Statistical analysis was performed using IBM SPSS version 22. Quantitative variables were analysed by mean and standard deviation (SD) while categorical variables were analysed by frequency and proportion. Median and interquartile range (IQR) were used for non-normally distributed quantitative variables. Comparison of categorical outcomes was done between study groups using Chi-square test/Fisher's Exact test. At different time periods, categorical variables were compared using the McNemar test. For quantitative parameters with normal distribution, the mean values were compared between study groups using an independent sample t-test (2 groups). Change in the quantitative parameters before and after the intervention was assessed by paired t-test. P value < 0.05 was considered statistically significant.

Results

Between September 2021 to July 2022, 70 patients were randomized into Group A-stenting (n-35) and Group B- no stenting (n-35). Sixty-six patients were included in the final analysis. The baseline characteristics were comparable between the 2 groups. Ten (15.15%) patients had a recurrence of CBDS and it was comparable between the 2 groups [7/34 (20.59%) and 3/32 (9.38%), p=0.306]. Two patients in the stent group developed biliary complication (cholecystitis) while none of the patients in the no stent group developed any biliary complication. Three patients in the stent group while none in the no-stent group developed post-ERC pancreatitis (p=0.085). None of the patients in both the groups needed emergency ERC during the follow-up.

	Stent group (n-34)	No stent group (n-32)	P value
Primary outcome
Recurrence of CBDS	7(20.59%)	3(9.38%)	0.306
Secondary outcomes
Biliary and pancreatic complications -Jaundice -Cholangitis -Cholecystitis -Pancreatitis	0 0 2 0	0 0 0 0	0.164
Need for repeat ERC	6(18.18%)	3(9.38%)	0.475
Post ERC pancreatitis	3	0	0.085

Conclusion

This randomized trial shows no advantage of prophylactic stenting in preventing CBDS recurrence or biliary complications in patients waiting for cholecystectomy after biliary clearance. (CTRI registration number: CTRI/2021/09/036538)

Conference

UEG Week Copenhagen 2023

Topics

Hepatobiliary

Submission format

Abstract

Session

Hepatobiliary endoscopy: Nothing stays the same (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Indications, contraindications and management of liver transplantation in acute liver failure

Annalisa Berzigotti

THERAPEUTIC TARGETING OF SECRETED OSTEOPONTIN ATTENUATES THE FIBROTIC PHENOTYPE IN EXPERIMENTAL CHRONIC PANCREATITIS

Pieter Hindryckx

SUSTAINED REAL-WORLD EFFECTIVENESS OF FILGOTINIB IN ULCERATIVE COLITIS: 12- AND 18-MONTH OUTCOMES FROM A MULTICENTRE COHORT (FILGUITO STUDY)

Federico Argüelles-Arias

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New

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Indications, contraindications and management of liver transplantation in acute liver failure

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Indications, contraindications and management of liver transplantation in acute liver failure

Annalisa Berzigotti 1

Affiliations

1 Inselspital, University Hospital of Berne, Berne, Switzerland

Summary

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Abstract

Event

Postgraduate Teaching Programme Barcelona 2026

Topics

Surgery Hepatobiliary

Session

Decision-making in acute liver failure: From expectant management to emergency transplant

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

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Indications, contraindications and management of liver transplantation in acute liver failure

Annalisa Berzigotti

THERAPEUTIC TARGETING OF SECRETED OSTEOPONTIN ATTENUATES THE FIBROTIC PHENOTYPE IN EXPERIMENTAL CHRONIC PANCREATITIS

Pieter Hindryckx

SUSTAINED REAL-WORLD EFFECTIVENESS OF FILGOTINIB IN ULCERATIVE COLITIS: 12- AND 18-MONTH OUTCOMES FROM A MULTICENTRE COHORT (FILGUITO STUDY)

Federico Argüelles-Arias

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George Webster

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Giuseppe Malleo

Welcome to the theatre: Interventional treatment in acute pancreatitis – the secrets of endoscopy vs. indications and contraindications for surgery

Sanjay Pandanaboyana

UEG Presentation

New

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THERAPEUTIC TARGETING OF SECRETED OSTEOPONTIN ATTENUATES THE FIBROTIC PHENOTYPE IN EXPERIMENTAL CHRONIC PANCREATITIS

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THERAPEUTIC TARGETING OF SECRETED OSTEOPONTIN ATTENUATES THE FIBROTIC PHENOTYPE IN EXPERIMENTAL CHRONIC PANCREATITIS

Emine Gökce 1, Lindsey Devisscher 2, Niki Rashidian 1, Pieter Hindryckx 1

Affiliations

1 Ghent University Hospital, Ghent, Belgium

2 Ghent University, Ghent, Belgium

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Abstract

Introduction

Chronic pancreatitis (CP) is a progressive and irreversible fibro-inflammatory disease of the pancreas, characterized by acinar loss and fibrosis, for which no curative therapy exists. Secreted osteopontin (sOPN) is a matricellular cytokine increasingly recognized as a key mediator of fibrosis in multiple organs, including the liver, lung and pancreas. However, its potential as a therapeutic target in CP remains unexplored.

Aims & Methods

This study investigated whether sOPN contributes to pancreatic fibrogenesis in experimental CP. CP-like injury was induced in mice by six intraperitoneal cerulein injections (50 µg/kg every hour) three days per week, combined with ethanol injections (33%, 3×/week) for 6 weeks. Anti-OPN antibody (200µg, 3×/week) was administered to neutralize secreted OPN. Serum sOPN levels were measured by ELISA. Pancreatic RNA was isolated for qPCR analysis of inflammatory and fibrotic markers, and fibrosis was additionally evaluated histologically using Sirius Red staining. Immunohistochemistry for α-SMA was performed and quantified to evaluate pancreatic stellate cell activation.

Results

Six-weekly injections of cerulein and ethanol induced a consistent CP-like phenotype, characterised by acinar cell loss, inflammatory cell infiltration and fibrosis. Circulating sOPN levels were significantly higher in mice with CP compared to healthy mice, and significantly decreased upon anti-OPN-Ab treatment (Δ = -98514; 95% CI -180392 to -16636; p = 0.0209). Histological analysis showed a significant reduction in pancreatic fibrosis, with less collagen deposition on Sirius Red staining (Δ = -1.648, 95% CI -2.766 to -0.530; p = 0.0064). Immunohistochemical analysis of α-SMA also showed a significant reduction, suggesting decreased pancreatic stellate cell activation (Δ = -3.636; 95% CI -5.351 to -1.920; p = 0.0004). Pancreatic α-SMA and CTGF mRNA expression showed a significant reduction after OPN blockade (α-SMA: Δ = -72.91; 95% CI -117.8 to -28.04; p = 0.0028; CTGF: Δ = -3.112; 95% CI -5.542 to -0.681; p = 0.0147), accompanied by significant downregulation of pro-fibrotic genes, including Col1a1 (Δ = -6.467; 95% CI -11.02 to -1.911; p = 0.0077), Col3a1 (Δ = -5.097; 95% CI -8.201 to -1.994; p = 0.0026), and MMP2 (Δ = -2.659; 95% CI -5.318 to -0.0002; p = 0.0500), indicating attenuation of the fibrotic phenotype.

Conclusion

Blocking secreted OPN significantly reduced serum OPN levels, markers of pancreatic stellate cell activation, and markers of fibrogenic gene expression in experimental CP. Additionally, histology showed significantly less collagen deposition, identifying secreted OPN as a potential therapeutic target in CP.

Event

UEG Week Barcelona 2026

Topics

Gut Microbiota Endoscopy Radiology & Imaging Pancreas

Submission format

Abstract

Session

Chronic pancreatitis

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

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Annalisa Berzigotti

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Pieter Hindryckx

SUSTAINED REAL-WORLD EFFECTIVENESS OF FILGOTINIB IN ULCERATIVE COLITIS: 12- AND 18-MONTH OUTCOMES FROM A MULTICENTRE COHORT (FILGUITO STUDY)

Federico Argüelles-Arias

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UEG Poster

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SUSTAINED REAL-WORLD EFFECTIVENESS OF FILGOTINIB IN ULCERATIVE COLITIS: 12- AND 18-MONTH OUTCOMES FROM A MULTICENTRE COHORT (FILGUITO STUDY)

Antonio M Caballero-Mateos 1, Teresa Valdes-Delgado 2, Claudio Trigo Salado 3, Álvaro Suárez Toribio 3, Paula Castro-Martínez 2, Maria Mar Martin Rodriguez 4, Francisco Javier Rodriguez-González 5, Alvaro Hernández Martínez 6, Alfonso Extremera Fernández 7, Marta Librero Jiménez 8, Hector Pallares Manrique 9, Ana Maria Trapero-Martínez 10, JOSE MANUEL BENITEZ CANTERO 11, Raúl Olmedo-Martín 12, Nuria Fernandez Moreno 13, Pablo Florez Diez 14, Federico Argüelles-Arias 15

Affiliations

1 Hospital Clínico San Cecilio, Granada, Spain

2 Hospital Universitario Virgen Macarena, Seville, Spain

3 Hospital Universitario Virgen del Rocío, Seville, Spain

4 Hosp. Universitario Virgen De Las Nieves General, Granada, Spain

5 Hospital Universitario Virgen de la Victoria, Málaga, Spain

6 Hospital Universitario Torrecárdenas, Almería, Spain

7 Hospital Universitario San Cecilio, Granada, Spain

8 Hospital Comarcal Santa Ana de Motril, Motril, Spain

9 H. Juan Ramon Jimenez, Huelva, Spain

10 Complejo Hospitalario de Jaén, Jaén, Spain

11 Hospital Universitario Reina Sofia, Cordoba, Spain

12 Hospital Regional de Málaga, Málaga, Spain

13 Hospital Universitario Costa del Sol, Marbella, Spain

14 Hospital Universitario Central de Asturias, Oviedo, Spain

15 Huv macarena, Sevilla, Spain

Summary

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Abstract

Introduction

Filgotinib has shown efficacy in ulcerative colitis (UC) in clinical trials, but long-term real-world data are scarce, particularly in patients with prior biologic exposure. We aimed to evaluate the durability of response to filgotinib, focusing on 12- and 18-month outcomes.

Aims & Methods

This retrospective multicentre study included UC patients initiating filgotinib across 13 Andalusian (Spain) hospitals. Clinical activity (partial Mayo score), C-reactive protein, and faecal calprotectin were assessed longitudinally from baseline to 18 months. Clinical remission was defined as partial Mayo score <3; steroid-free remission as clinical remission without corticosteroid use; and combined clinical-biochemical remission as clinical remission with normalization of inflammatory markers (CRP and faecal calprotectin <250 µg/g). Subgroup analyses were performed according to prior biologic exposure.

Results

Outcome	Baseline	Week 8	Week 16	6M	12M	18M
Partial Mayo (median)	6	2	1	0	0	0
CRP mg/L (median)	5	2.2	2.3	2	1	1
Calprotectin µg/g (median)	2000	427.2	347	249	160	173.5
Clinical remission (%)	7.8	59.8	58.0	58.9	50.7	39.7
Clinical-biochemical (%)	3.4	31.4	23.9	31.1	26.0	22.4

A total of 118 patients were included, with a mean disease duration of 12.4 years and a high rate of prior advanced therapies (mean 1.9) (table 1-2). Clinical and biochemical improvements observed early were sustained over time. At 12 months, clinical remission was achieved in 50.7% of patients, with 26.0% reaching combined clinical-biochemical remission and 37.0% achieving steroid-free remission. At 18 months, clinical remission persisted in 39.7%, with 22.4% maintaining combined remission and 24.1% remaining steroid-free. Median partial Mayo score remained at 0, and inflammatory markers (CRP and faecal calprotectin) were consistently reduced from baseline, indicating sustained disease control (table 1). Treatment effectiveness was influenced by prior biologic exposure, with higher remission rates in less pre-treated patients. Only 2.8% of patients required treatment discontinuation due to adverse events.

Conclusion

In this real-world multicentre cohort, filgotinib demonstrated durable effectiveness up to 18 months in patients with UC, including a heavily pre-treated population. Approximately half of patients maintained clinical remission at 1 year, with sustained steroid-free and biochemical control in a substantial proportion. These findings support the role of filgotinib as a long-term therapeutic option, with greater benefit when used earlier in the treatment sequence.

References

Caballero-Mateos AM, Trigo-Salado C, Suárez-Toribio Á, Martín-Rodríguez MDM, Rodríguez-González FJ, Valdés-Delgado T, Pallarés-Manrique H, Trapero-Martínez AM, Olmedo-Martín R, Bailón-Gaona C, Benitez Cantero JM, Gros B, Sáez-Díaz A, Hernández-Martínez Á. Long-term clinical outcomes with filgotinib in ulcerative colitis: 12-month results from the FILGUITO study. World J Gastroenterol. 2026 Feb 14;32(6):115941. doi: 10.3748/wjg.v32.i6.115941.

Disclosure

FAA has received fees for lectures, consultancy work, or research support from: Lilly, Abbvie, Johnson & Johnson, Takeda, Pfizer, Alfasigma, Ferring, Farmasierra, Kern, Faesfarma.

Conference

UEG Week Barcelona 2026

Topics

IBD

Submission format

Abstract

Session

IBD (INCLUDING MICROSCOPIC COLITIS) (Posters)

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

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Pieter Hindryckx

SUSTAINED REAL-WORLD EFFECTIVENESS OF FILGOTINIB IN ULCERATIVE COLITIS: 12- AND 18-MONTH OUTCOMES FROM A MULTICENTRE COHORT (FILGUITO STUDY)

Federico Argüelles-Arias

What are the opportunities for endoscopic therapy?

George Webster

Is robotic resection better for cystic lesions?

Giuseppe Malleo

Welcome to the theatre: Interventional treatment in acute pancreatitis – the secrets of endoscopy vs. indications and contraindications for surgery

Sanjay Pandanaboyana

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

What are the opportunities for endoscopic therapy?

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What are the opportunities for endoscopic therapy?

George Webster 1

Affiliations

1 University College Hospital, London, United Kingdom

Summary

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Abstract

Event

UEG Week Barcelona 2026

Topics

Surgery Pancreas Endoscopy

Session

Daily questions in the management of chronic pancreatitis

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

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Indications, contraindications and management of liver transplantation in acute liver failure

Annalisa Berzigotti

THERAPEUTIC TARGETING OF SECRETED OSTEOPONTIN ATTENUATES THE FIBROTIC PHENOTYPE IN EXPERIMENTAL CHRONIC PANCREATITIS

Pieter Hindryckx

SUSTAINED REAL-WORLD EFFECTIVENESS OF FILGOTINIB IN ULCERATIVE COLITIS: 12- AND 18-MONTH OUTCOMES FROM A MULTICENTRE COHORT (FILGUITO STUDY)

Federico Argüelles-Arias

What are the opportunities for endoscopic therapy?

George Webster

Is robotic resection better for cystic lesions?

Giuseppe Malleo

Welcome to the theatre: Interventional treatment in acute pancreatitis – the secrets of endoscopy vs. indications and contraindications for surgery

Sanjay Pandanaboyana

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Is robotic resection better for cystic lesions?

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Is robotic resection better for cystic lesions?

Giuseppe Malleo 1

Affiliations

1 Unit of General and Pancreatic Surgery, University of Verona Hospital Trust, Verona, Italy

Summary

AI Generated

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Abstract

Event

UEG Week Berlin 2025

Topics

Digestive Oncology Gut Microbiota Pancreas

Session

Cystic neoplasms of the pancreas

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Indications, contraindications and management of liver transplantation in acute liver failure

Annalisa Berzigotti

THERAPEUTIC TARGETING OF SECRETED OSTEOPONTIN ATTENUATES THE FIBROTIC PHENOTYPE IN EXPERIMENTAL CHRONIC PANCREATITIS

Pieter Hindryckx

SUSTAINED REAL-WORLD EFFECTIVENESS OF FILGOTINIB IN ULCERATIVE COLITIS: 12- AND 18-MONTH OUTCOMES FROM A MULTICENTRE COHORT (FILGUITO STUDY)

Federico Argüelles-Arias

What are the opportunities for endoscopic therapy?

George Webster

Is robotic resection better for cystic lesions?

Giuseppe Malleo

Welcome to the theatre: Interventional treatment in acute pancreatitis – the secrets of endoscopy vs. indications and contraindications for surgery

Sanjay Pandanaboyana

UEG Presentation

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Welcome to the theatre: Interventional treatment in acute pancreatitis – the secrets of endoscopy vs. indications and contraindications for surgery

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Welcome to the theatre: Interventional treatment in acute pancreatitis – the secrets of endoscopy vs. indications and contraindications for surgery

Andrada Seicean 1, Sanjay Pandanaboyana 2

Affiliations

1 University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Romania, Cluj Napoca, Romania

2 Freeman hospital, Newcastle upon tyne, United Kingdom

Summary

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Abstract

Event

Postgraduate Teaching Programme Barcelona 2026

Session

Acute pancreatitis: Are we still innocent bystanders?

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

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Indications, contraindications and management of liver transplantation in acute liver failure

Annalisa Berzigotti

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Pieter Hindryckx

SUSTAINED REAL-WORLD EFFECTIVENESS OF FILGOTINIB IN ULCERATIVE COLITIS: 12- AND 18-MONTH OUTCOMES FROM A MULTICENTRE COHORT (FILGUITO STUDY)

Federico Argüelles-Arias

What are the opportunities for endoscopic therapy?

George Webster

Is robotic resection better for cystic lesions?

Giuseppe Malleo

Welcome to the theatre: Interventional treatment in acute pancreatitis – the secrets of endoscopy vs. indications and contraindications for surgery

Sanjay Pandanaboyana