Summary

Transjugular intrahepatic portosystemic shunt (TIPS) placement is a well-established procedure for managing complications of portal hypertension. In recent years, the field of TIPS has seen rapid advances, particularly in technical approaches, prognostic modelling, and an expanding range of indications. The aim of these EASL guidelines is to comprehensively address all aspects of TIPS in patients with cirrhosis. Other related topics, such as the use of TIPS in surgical settings and in vascular liver disorders, are covered in separate dedicated clinical practice guidelines.

Abstract

Pelvic exenteration (PE) is a radical surgical approach designed for the curative treatment of advanced pelvic malignancies, requiring en-bloc resection of multiple pelvic organs. While the procedure is radical, it has shown promise in enhancing long-term survival and is now comparable in surgical mortality to elective resections for primary pelvic cancers. Imaging plays a crucial role in preoperative planning, with MRI, CT, and PET/CT being pivotal in assessing the extent of cancer and formulating a surgical roadmap. This paper presents clinical practice guidelines for imaging in the context of PE, developed jointly by ESGAR, SAR, ESUR, and the PelvEx Collaborative. These guidelines aim to standardise imaging protocols and reporting to improve the preoperative assessment and facilitate decision-making in the multidisciplinary treatment of pelvic cancers. Our recommendations underscore the importance of a multidisciplinary approach and the need for clear and precise imaging reports to optimise patient care.

Clinical relevance statement

Our recommendations underscore the importance of a multidisciplinary approach and the need for clear and precise imaging reports to optimise patient care.

Key Points

• MRI is mandatory for local staging in pelvic exenteration.

• Structured reporting (using the template provided in this guide) is recommended.

• Multidisciplinary review of imaging is critical for surgical planning.

Summary

Hepatitis D virus (HDV) is a defective virus that requires the hepatitis B virus to complete its life cycle and cause liver damage in humans. HDV is responsible for rare acute and chronic liver diseases and is considered the most aggressive hepatitis virus. Acute infection can cause acute liver failure, while persistent infection typically causes a severe form of chronic hepatitis which is associated with rapid and frequent progression to cirrhosis and its end-stage complications, hepatic decompensation and hepatocellular carcinoma. Major diagnostic and therapeutic innovations prompted the EASL Governing Board to commission specific Clinical Practice Guidelines on the identification, virologic and clinical characterisation, prognostic assessment, and appropriate clinical and therapeutic management of HDV-infected individuals.

Keywords

Abstract

INTRODUCTION

Diet is gaining recognition amongst clinicians, researchers, and the inflammatory bowel disease [IBD] community as a potential modifier to change the course of the disease. The role of diet in the management of IBD has evolved beyond adjustment for nutritional needs and is now applied as therapy to influence disease activity and complications. With growing recognition of diet, there is a demand for high-quality dietary research to guide practice and consideration on where to best position diet in the treatment paradigm. This has led to the commissioning of this first European Crohn’s and Colitis Organisation [ECCO] consensus on dietary management of IBD, with the goal of providing evidence-based recommendations to guide clinical practice.