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EUS-TCB is not superior to EUS-FNA in GISTs because of the high rate of technical failure of trucut. However, when an adequate sample is obtained with EUS-TCB, immunohistochemical phenotyping is almost always possible. EUS-TCB can be safely performed in this set of patients.

Deranged intestinal motility, which occurs in cirrhosis, may facilitate the development of intestinal bacterial overgrowth (IBO), which can lead to bacterial translocation (BT). To assess the effect of cisapride on IBO and BT in cirrhosis, cirrhotic rats received cisapride or a placebo for 7 days, and measurements of jejunal bacterial content and BT studies were performed. In addition, jejunal fluid from 46 cirrhotic patients was obtained for quantitative bacterial culture. Those patients in whom gram-negative IBO was detected were randomized to receive or not to receive cisapride (20 mg twice per day) for 1 week. Cisapride significantly reduced IBO in cirrhotic rats. In addition, no BT was documented in treated animals, whereas it occurred in 40% in nontreated cirrhotic rats. Total IBO was documented in 23 of 46 cirrhotic patients, which was caused by gram-negative organisms in 10 cases. Orocecal transit time (OCT) significantly decreased after cisapride therapy, and was associated with the abolishment of bacterial overgrowth caused by gram-negative organisms in 4 out of 5 treated patients, whereas it persisted in nontreated cases. Cisapride administration to cirrhotic rats resulted in a reduction of the IBO, which is associated with a marked decrease in BT. On the other hand, cisapride facilitates the abolition of IBO caused by gram-negative organisms in cirrhotic patients. (HEPATOLOGY 2000;31:858-863.)

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*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%)

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