What stood out in the hepato-pancreato-biliary programme at UEG Week 2026? Jörn Schattenberg, chair of the UEG Scientific Committee, asks endoscopist and pancreatologist Livia Archibugi for her highlights. Her verdict: the innovation lay less in new technology than in using existing tools more smartly.

They discuss a randomised trial from China comparing same-session EUS-ERCP with ERCP alone, in which the EUS-first strategy avoided 17% of unnecessary ERCPs and reduced fluoroscopy time, and how knowing the anatomy behind the papilla can shape the cannulation strategy. Turning to metabolic liver disease, they consider incretin-based therapies and retained gastric content at endoscopy in patients on GLP-1 receptor agonists, where a defined protocol is still lacking. Two pharmacological abstracts follow: peppermint oil versus UDCA to prevent recurrent bile duct stones, with a borderline, non-significant advantage, and celecoxib in predicted non-mild acute pancreatitis, which lowered organ failure but needs larger trials. The conversation closes on genetics: a French PRSS1 cohort with a lower cancer risk than previously reported, polygenic risk scores, and why surveillance of high-risk individuals remains hard to justify on cost-effectiveness grounds.

Research and further reading

Discussed in the episode (UEG Week 2026 presentations, recordings on Gutflix):

• Effect of same-session endoscopic ultrasonography on endoscopic retrograde cholangiopancreatography in pancreaticobiliary diseases: a randomized controlled trial. Zhen Li. UEG Week 2026, abstract OP200. The same-session EUS-ERCP trial from China.
• Peppermint oil versus ursodeoxycholic acid for preventing recurrent choledocholithiasis after ERCP stone clearance: a 2-year prospective randomized controlled trial. Haitao Huang. UEG Week 2026, abstract OP201.
• Prevention of acute pancreatitis related organ failure with early use of celecoxib: an investigator-initiated, prospective, multi-center, double-blind, randomized, placebo-controlled clinical trial. Luming Huang. UEG Week 2026, abstract OP117. The multicentre trial from China in predicted non-mild acute pancreatitis.
• Natural history of PRSS1 hereditary pancreatitis: a 30-year French nationwide cohort (PARADISIO-1). Guillaume Cléry. UEG Week 2026, abstract OP306. Penetrance, exocrine and endocrine insufficiency, and pancreatic cancer risk.
• The association of sweetened beverages with pancreatic cancer and their interaction with genetics. Jiaxi Lin. UEG Week 2026, moderated poster MP0200. The polygenic risk score study; no recording on Gutflix.

Session mentioned in the episode ("Therapy update: Anti-obesity", incretin-based therapies):

• Treating obesity: From mechanism to personalization. Amalia Gastaldelli. UEG Week 2026.
• Nutritional aspects: How to provide baseline therapy. Julia Mader. UEG Week 2026.
• Targeting the liver: Effects beyond obesity. Naim Alkhouri. UEG Week 2026.

Guideline mentioned in the episode:

• ASGE guideline on screening for pancreatic cancer in individuals with genetic susceptibility: summary and recommendations. Sawhney MS et al. Gastrointestinal Endoscopy, 2022. The ASGE guidance Livia Archibugi refers to on surveillance of high-risk individuals. https://pubmed.ncbi.nlm.nih.gov/35183358/

Additional further reading (not mentioned by name in the episode):

• Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer. O'Reilly EM et al. New England Journal of Medicine, 2026. Phase 3 data for the RAS(ON) inhibitor mentioned as a new targeted option in pancreatic cancer. https://pubmed.ncbi.nlm.nih.gov/42223072/
• A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. Harrison SA et al. New England Journal of Medicine, 2024. The pivotal trial behind resmetirom, the approved MASH therapy mentioned in the episode. https://pubmed.ncbi.nlm.nih.gov/38324483/
• Multisociety Clinical Practice Guidance for the Safe Use of Glucagon-like Peptide-1 Receptor Agonists in the Perioperative Period. Kindel TL et al. Clinical Gastroenterology and Hepatology, 2025. Periprocedural guidance relevant to the discussion of fasting and retained gastric content. https://pubmed.ncbi.nlm.nih.gov/39480373/
• Prevention of Severe Acute Pancreatitis With Cyclooxygenase-2 Inhibitors: A Randomized Controlled Clinical Trial. Huang Z et al. American Journal of Gastroenterology, 2020. Earlier single-centre trial from China of sequential parecoxib and celecoxib in predicted severe acute pancreatitis. https://pubmed.ncbi.nlm.nih.gov/32142484/
• The natural history of hereditary pancreatitis: a national series. Rebours V et al. Gut, 2009. Earlier French national cohort of hereditary pancreatitis, largely PRSS1-related. https://pubmed.ncbi.nlm.nih.gov/18755888/