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Crescent Gastroliver & General Hospital
GI & HEPATOBILIARY UPDATES

EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease


European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD) and European Association for the Study of Obesity (EASO).


The Clinical Practice Guidelines propose recommendations for the diagnosis, treatment and follow-up of non-alcoholic fatty liver disease (NAFLD) patients and are the product of a joint effort by the European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD) and Euro-pean Association for the Study of Obesity (EASO). They update a position statement based on the 2009 EASL Special Conference.



Canulation and Sphincterotomy

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It provides practical advice on how to achieve successful cannulation and sphincterotomy at minimum risk to the patient. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence.



ERCP management in Bile duct injury

It was really a tough case. The pt had Lap Chole on 15 Nov, Bile duct injury happened then. Everybody missed it. She had pain, nausea+vomiting since then. She was a bit icteric. Ascites was discovered on USG (collection), and it was aspirated. Operating surgeon, Internal medicine specialist was following up. Finally a `would be Gastroenterologist' saw her, got a MRCP done. It revealed stricture at CBD, dilated CHD & IHBT, and evidence of bile leakage at the level of cystic duct. It wasn't easy to cannulate, and we could negotiate the guide wire upto CHD+IHBT with difficulty. Finally we put a 10frX10cm plastic biliary stent and free flow of bile was established.