Identifying low muscle mass at anti-TNF induction as a risk factor for treatment failure may contribute to a more tailored approach to IBD therapy.

Background and Aim During COVID‐19 outbreak, restrictions to in‐person consultations were introduced with a rise in telehealth. An indirect benefit of telehealth could be better attendance. This study aimed to assess “failure‐to‐attend” (FTA) rate and satisfaction for two endoscopy‐related compulsory telehealth clinics during the COVID‐19 outbreak. Methods Consecutive patients booked for endoscopy‐related telehealth clinics at a tertiary hospital were prospectively assessed. In‐person clinic control data was assessed retrospectively. Sample size was calculated to detect an anticipated increase in attendance of 8%. Secondary outcomes included FTA differences between clinics and evaluation of patients and doctors satisfaction. Satisfaction was assessed based on 6 Likert scale questions used in previous telehealth research and asked to both patients and doctors (6Q_score). This study was exempt from IRB review after institutional IRB review. Results 691 patients were booked for appointments in our endoscopy clinics during the study periods (373 in 2020). FTA rates were lowered by half during the compulsory telehealth clinics (12.6% to 6.4%, p<0.01). The patient 6Q_score was higher for the Advanced Endoscopy clinic (84.6% versus 73.8%, p<0.01), while the doctor 6Q_score was similar between both Advanced and Post Endoscopy clinics (91.1% versus 92.5% respectively, p=0.80). An in‐person follow‐up consultation was suggested for 3.5% of the appointments, while the necessity of physical examination was flagged in 5.1%. Conclusions The use of phone consultations in endoscopy‐related clinics during the COVID‐19 outbreak has improved FTA rates while demonstrating high satisfaction rates. The need for in‐person follow‐up consultations and physical examination were low.

conceptualized and designed the study. Sujievvan Chandran was responsible for the study supervision. All authors were involved in data extraction. Leonardo Zorron Cheng Tao Pu and Ryma Terbah were involved in the statistical analyses. All authors helped with interpretation of the results and drafting the manuscript. Rhys Vaughan, Marios Efthymiou, and Sujievvan Chandran carried the critical revision of the article for important intellectual content. All authors read and approved the final version of the manuscript.

Background and AimCholecystectomy and endoscopic retrograde cholangiopancreatography are the gold standard for managing acute cholecystitis and malignant biliary obstruction, respectively. Recent advances in therapeutic endoscopic ultrasound (EUS) have provided alternatives for managing patients in whom these approaches fail, namely, EUS‐guided gallbladder drainage (EUS‐GB) and EUS‐guided bile duct drainage (EUS‐BD). We aimed to assess the technical and clinical success of these techniques in the largest multicenter cohort published to date.MethodsA retrospective, multicenter, observational study involving 17 centers across Australia and New Zealand was conducted. All patients who had EUS‐GB or EUS‐BD performed in a participating center using a lumen apposing metal stent between 2016 and 2020 were included. Primary outcome was technical success, defined as intra‐procedural successful drainage. Secondary outcomes included clinical success and 30‐day mortality.ResultsOne hundred and fifteen patients underwent EUS‐GB (n = 49) or EUS‐BD (n = 66). EUS‐GB was technically successful in 47 (95.9%) while EUS‐BD was successful in 60 (90.9%). All failed cases were due to maldeployment of the distal flange outside of the targeted lumen. Clinical success of EUS‐GB was achieved in 39 (79.6%). No patients required subsequent cholecystectomy. Clinical success of EUS‐BD was achieved in 52 (78.8 %). Thirty‐day mortality was 14.3% for EUS‐GB and 12.1% for EUS‐BD.ConclusionsEUS‐guided gallbladder drainage and EUS‐BD are promising alternatives for managing nonsurgical candidates with cholecystitis and malignant biliary obstruction following failed endoscopic retrograde pancreatography. Both techniques delivered high technical success with acceptable clinical success. Further research is needed to investigate the gap between technical and clinical success.