COMMENTARY

The Year in Gastroenterology: 10 Practice-Changing, Must-Read Studies

David A. Johnson, MD

Disclosures

December 20, 2017

Updated Guideline on the Management of Common Bile Duct Stones (CBDS)

Williams E, Beckingham I, El Sayed G, et al
Gut. 2017;66:765-782

This British guideline updates the 2008 evidence-based recommendations for CBDS and supplements the 2011 guideline from the American Society of Gastrointestinal Endoscopy on this topic.

Most notable among the findings are the emerging recommendations for the use of rectal indomethacin and pancreatic stent placement for post-endoscopic retrograde cholangiopancreatography pancreatitis risk reduction (in high-risk patients) and the push to have cholecystectomy performed during the hospital admission for those with biliary pancreatitis.

Abstract

Competing Risks for Mortality in Patients With Asymptomatic Pancreatic Cystic Neoplasms: Implications for Clinical Management

Kwok K, Chang J, Duann L, Huang BZ, Wu BU
Am J Gastroenterol. 2017;112:1330-1336

Clinicians know that cystic pancreatic lesions are a very frequent incidental finding in patients who undergo abdominal diagnostic imaging by CT or MRI. Differing recommendations among recent national and international guidelines have made the management of these incidentally detected symptomatic lesions somewhat controversial. This excellent analysis focuses on new perspectives on the prevalence and management, as directed by patient-related factors in conjunction with cyst features.

Abstract

American Gastroenterological Association Institute Guideline on Therapeutic Drug Monitoring in Inflammatory Bowel Disease

Feuerstein JD, Nguyen GC, Kupfer SS, Falck-Ytter Y, Singh S; American Gastroenterological Association Institute Clinical Guidelines Committee
Gastroenterology. 2017;153:827-834

There has undoubtedly been an increase in expert recommendations for using therapeutic drug monitoring (TDM) to optimize the management of inflammatory bowel disease (IBD).

This guideline on TDM covers both anti-tumor necrosis factor agents and thiopurines and provides the current best-practice recommendations for clinicians prescribing and monitoring these therapies. It also provides important guidance on acceptable antibody levels for other available biological agents used in the treatment of IBD.

Abstract

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