30-Second Takeaway
- Minor papillotomy for pancreas divisum–associated idiopathic recurrent pancreatitis offers no clear benefit over sham in a rigorous RCT.
- Cyclic fasting-mimicking diet improves symptoms and fecal calprotectin in mild–moderate Crohn’s disease versus baseline diet.
- Liver transplantation delivers better long-term survival than resection for HCC when feasible across standard and expanded criteria.
Week ending January 17, 2026
Pancreas, bowel, and liver updates: challenging ERCP dogma, diet for Crohn’s, and evolving hepatology tools
Minor papillotomy fails to prevent recurrent pancreatitis in pancreas divisum
In adults with idiopathic acute recurrent pancreatitis and pancreas divisum, ERCP with minor papillotomy did not significantly reduce recurrent pancreatitis versus sham. Over a median 34-month follow-up, pancreatitis occurred in 34.7% with papillotomy and 43.8% with sham (adjusted HR 0.83; 95% CI 0.49–1.41). Episode frequency and development of chronic calcific pancreatitis, diabetes, or exocrine dysfunction were similar between groups. These data challenge routine minor papillotomy for unexplained recurrent pancreatitis in pancreas divisum and support more conservative, nonprocedural strategies.
Fasting-mimicking diet improves mild–moderate Crohn’s disease activity
Adults with mild-to-moderate Crohn’s disease were randomized to a 5-day-per-month fasting-mimicking diet (FMD) for three months versus baseline diet. Clinical response after three cycles occurred in 69.2% of FMD patients versus 43.8% of controls (P = 0.03). Clinical remission was achieved in 64.6% with FMD and 37.5% with baseline diet (P = 0.02). FMD also produced a greater reduction in fecal calprotectin than control (-22.0% vs 8.0%; P = 0.03), consistent with reduced intestinal inflammation. These findings support structured, cyclic FMD as an adjunctive therapy for symptom and biomarker improvement in stable, mild–moderate Crohn’s disease.
Transplant outperforms resection for hepatocellular carcinoma survival
This umbrella review synthesized meta-analyses comparing liver transplantation (LT) with liver resection (LR) for hepatocellular carcinoma. Pooled hazard ratios favored LT for overall survival (HR 1.35; 95% CI 1.17–1.55) and disease-free survival (HR 2.58; 95% CI 2.25–2.96). Benefits were consistent across Milan and extended criteria, viral etiologies, eras, and geographic regions. The synthesis reinforces LT as the preferred curative strategy for eligible HCC patients, while LR remains essential where grafts are unavailable or contraindicated.
References
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Additional Reads
Optional additional studies from this edition.