*No differences in the incidence of infection or other events 500 mg bid (3 days) 200 mg iv (1 dose) • Infection after EUS-FNA is low • The use of antibiotic prophylaxis is conflicting Antibiotic Prophylaxis is Not Needed for EUS-guided FNA of Pancreatic Cystic Lesions: a Clinical Trial Results: • Non-inferiority multicenter clinical trial 226 iv (1 dose) bid (3 days) 112 ciprofloxacin 0 (0%) 2 (1.78%) 6 (5.4%) Infection Fever Other events 114 placebo 1 (0.87%) 2 (1.76%) 8 (7%)

The rate of AEs after ERCP is higher in patients with cirrhosis compared to the non-cirrhotic population. The incidence of ACLF is higher in those with AEs after ERCP compared to those without AEs, especially cholangitis. The development of ACLF is common after ERCP and other invasive procedures. ACLF can be precipitated by numerous factors which include preceding events before the procedure, including manipulation of the bile duct, and AEs after an ERCP.

No abstract

In this descriptive study, we examined the role of single‐operator cholangioscopy (SOC) in the evaluation of biliary complications after liver transplantation (LT). We prospectively included adult recipients of deceased donor LT who were referred for endoscopic retrograde cholangiopancreatography between June 2009 and July 2011. All patients underwent SOC with biopsy of the biliary anastomosis. Sixteen patients were included: 12 with biliary anastomotic strictures (ASs), 2 with common bile duct stones, 1 with a bile leak, and 1 with sphincter of Oddi dysfunction. Patients with ASs displayed 1 of 2 patterns: (A) mild erythema (n = 9) or (B) edema, ulceration, and sloughing (n = 3). Those without ASs displayed a pale mucosa with mild edema at the anastomosis. Patients with ASs and pattern B required a longer period of stenting than patients with pattern A (457 versus 167 days, P = 0.01). In addition, patients with pattern A had a better response and better resolution of their strictures with endoscopic therapy than those with pattern B (88.9% versus 33.4%, P = 0.13). Histological examinations of ASs showed nonspecific intraepithelial inflammation in patients with patterns A and B. Biopsy samples from patients without ASs showed normal columnar epithelial bile duct cells. The total cholangioscopy time for all procedures was 26.8 ± 10.1 minutes. In conclusion, SOC in LT recipients is feasible and allows adequate visualization and tissue sampling of ASs and bile ducts. Two distinct visual patterns that are easily identified with SOC may help to predict the outcomes of endoscopic therapy in patients with biliary complications after LT. Liver Transpl 19:199‐206, 2013. © 2012 AASLD.