Endoscopic ampullectomy (or endoscopic resection of lesions associated with the ampulla of Vater) has now been performed for more than 25 years and has been supported by the literature, however, since its inception, the efficacy of this approach is still somewhat underappreciated. In our recent publication, despite its high success rate for clearance of ampullary adenomas, even with quite an extensive lateral spreading tumour component (LST-P), we wished to re-iterate and even celebrate the value of endoscopic ampullectomy, discuss our technique, highlight the risk of post procedural haemorrhage, discuss the adenoma recurrence rate and the need for a commitment to surveillance.

Liver biopsy continues to be the gold-standard with regards to diagnosis and staging of the majority of liver diseases. Serologic markers certainly have helped in diagnosing various autoimmune and viral-related liver diseases. Furthermore, laboratory testing and imaging studies such as liver elastography have allowed us to non-invasively assess fibrosis. Unfortunately, there are shortcomings with these forms of testing. False positives or laboratory errors will lead to misleading diagnoses. Situations can also arise during which there are diagnostic dilemmas, such as an obese patient with positive autoimmune serology and elevated liver chemistries.

Gastric cancer is one of the neoplasms with the highest degree of mortality worldwide, responsible for more than 780,000 deaths in 2018 and whose incidence has been increasing over the last few years, mainly in Asian and Latin American countries. The technological imaging advances in digestive endoscopy such as virtual chromoendoscopy and magnification associated with a systematic and comprehensive endoscopic examination of the entire gastric mucosa by a trained operator have optimized the early detection of pre-malignant and malignant lesions, which have favoured the high rate of curability through the use of endoscopic resection techniques such as endoscopic submucosal dissection (ESD).

In this study, the safety and efficacy of liver biopsies performed by endoscopic ultrasound (EUS-LB) were compared with those performed via the traditional percutaneous route at our Medical Center between January 2018 and August 2019.

A 40-year-old man received upper gastrointestinal endoscopic scan during a health check-up. There was no history suggestive of Helicobacter pylori eradication, reflux esophagitis, peptic ulcer disease and upper abdominal surgery. Endoscopy revealed a wide-mouthed diverticulum of the size of 1.5 × 2 cm between the fundus and greater curvature of the stomach (Figure 1).