EAES rapid guideline: updated systematic review, network meta-analysis, CINeMA and GRADE assessment, and evidence-informed European recommendations on the management of common bile duct stones.

BACKGROUND: Choledocholithiasis presents in a considerable proportion of patients with gallbladder disease. There are several management options, including preoperative or intraoperative endoscopic cholangiopancreatography (ERCP), and laparoscopic common bile duct exploration (LCBDE). OBJECTIVE: To develop evidence-informed, interdisciplinary, European recommendations on the management of common bile duct stones in the context of intact gallbladder with a clinical decision to intervene to both the gallbladder and the common bile duct stones. METHODS: We updated a systematic review and network meta-analysis of LCBDE, preoperative, intraoperative, and postoperative ERCP. We formed evidence summaries using the GRADE and the CINeMA methodology, and a panel of general surgeons, gastroenterologists, and a patient representative contributed to the development of a GRADE evidence-to-decision framework to select among multiple interventions. RESULTS: The panel reached unanimous consensus on the first Delphi round. We suggest LCBDE over preoperative, intraoperative, or postoperative ERCP, when surgical experience and expertise are available; intraoperative ERCP over LCBDE, preoperative or postoperative ERCP, when this is logistically feasible in a given healthcare setting; and preoperative ERCP over LCBDE or postoperative ERCP, when intraoperative ERCP is not feasible and there is insufficient experience or expertise with LCBDE (weak recommendation). The evidence summaries and decision aids are available on the platform MAGICapp ( https://app.magicapp.org/#/guideline/nJ5zyL ). CONCLUSION: We developed a rapid guideline on the management of common bile duct stones in line with latest methodological standards. It can be used by healthcare professionals and other stakeholders to inform clinical and policy decisions. GUIDELINE REGISTRATION NUMBER: IPGRP-2022CN170

New Mediterranean biodiversity records (December 2011)

The present work reports on recent biodiversity records of Mediterranean native species such as Olindias phosphorica in the Turkish Aegean Sea and extended distribution of eleven alien species in the Mediterranean. These are: Bursatella leachi (Mollusca, Gastropoda: Algeria); Callinectes sapidus (Crustacea, Decapoda: Greek Ionian Sea); Caprella scaura (Crustacea, Amphipoda: Mar Piccolo of Taranto); Fistularia commersonii (Fish: Saronikos Gulf, Aegean Sea); Sphoeroides pachygaster (Fish: South Turkey); Musculista perfragilis (Mollusca, Bivalvia: South Turkey); Sepioteuthis lessoniana (Mollusca, Cephalopoda: central eastern coast of Tunisia); Flabellina rubrolineata (Mollusca, opisthobranchia: central Aegean, Greece); Hesionura serrata (Polychaeta: Apulian coast); Stephanolepis diaspros (Fish: Saronikos Gulf, Aegean Sea); and Parvocalanus crassirostris (Crustacea, Copepoda: Lesvos Island, Greek Aegean Sea)