Enlarged fistulotomy of the papilla as access to the biliary tract during ERCP.

Background: Demonstration of access to the bile duct through Enlarged Papillary Fistulotomy, a method different from conventional fistulotomy.

Aims: Demonstration of the EFP technique with dissection in layers of the papilla for accessing the common bile duct, its efficiency and safety, rescue of cases of failure in cannulation and cases of access failure by EFP in the first attempt, facilitating cannulation in the second attempt.

Methods: Cross-sectional study, with retrospective data collection from 2233 ERCP exams with 528 EFP procedures, analysis of success and complications.

Quality of recovery in patients under low- or standard-pressure pneumoperitoneum. A randomised controlled trial.

Background: The use of low-pressure pneumoperitoneum seems to be capable of reducing complications such as post-operative pain. However, the quality of evidence supporting this conclusion is low. Both the lack of investigator blinding to both intra-abdominal pressure and to method of neuromuscular blockade represent key sources of bias.

Clinical, endoscopic and manometric features of the primary motor disorders of the esophagus.

Background: Significant incidence, diagnostic difficulties, clinical relevance and therapeutic efficacy associated with the small number of publications on the primary esophageal motor disorders, motivated the present study.

Aim: To determine the manometric prevalence of these disorders and correlate them to the endoscopic and clinical findings.

Methods: A retrospective study of 2614 patients, being 1529 (58.