Philip Dunne

Consultant Gastroenterologist @NHSGGC. @NHSResearchScot research fellow. Associate editor hepatology and endoscopy @FrontGastro_BMJ.

[Philip Dunne @DunnePdj]

@BritSocGastro update on portal hypertension guidance. 2015 guideline out of date but UK RCT results are pending. In the meantime time, we have written this update based on AASLD guidance with important caveats reflecting UK best practice and more recent data.

[Frontline Gastro @FrontGastro_BMJ]

🟠 Portal hypertension: beyond varices

New in Frontline Gastroenterology (Open Access): The BSG position statement supports interim use of AASLD guidance — with important UK caveats.

📍 Focus on clinically significant portal hypertension
📊 Use VCTE + platelets to risk stratify
✅ Carvedilol preferred where appropriate
🩺 Endoscopy still matters in the “grey zone”
⚠️ Individualise decisions around NSBB tolerance and contraindications

A timely update while UK trial data are awaited.

🔗 https://t.co/PuUk1QXiuI

#FrontlineGastroenterology #Hepatology #Cirrhosis #PortalHypertension #LiverTwitter

Fantastic co-author group: @DunnePdj @DTrip2015 @DrVishalCPatel @jamesbmaurice @drmarkmcphail @lynseycorless @IanARowe @EwanForrest1 @AdrianStanleyGI

@basl_events @heppharm @livernursing @LiverAHPs @Liver4Lifeuk @f4liverresearch @IQILS_Liver @LiverTrust @EASLedu @EASLnews @BritSocGastro @BavenoCoop @BCLC_group @ILCAnews @APASLnews @liverfellow @my_ueg @UKCPAGastro

@PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @BSGtrainees @drkeithsiau @ebtapper @DrLChina @acv69cardenas @GeriKeane @ClinicLiver

[Phil Smith @PhilSmithIsBack]

Another awesome paper, the second part of the series on Hepatic encephalopathy by @vtkronsten @DebbieShawcros1 et al @BASLedu @BSGTrainees @BritSocGastro #BASL2025

[Frontline Gastro @FrontGastro_BMJ]

👩‍⚕️👨‍⚕️ Still avoiding ERCP training due to radiation fears?

🛑 Let’s bust the myths.
📚 Stringer et al lay out the facts, risks & practical mitigations to promote safety, equity, and confidence.

💡 Guidance on PPE, pregnancy, ergonomics, and exposure monitoring.

🔗 https://t.co/7lXD5RW8Vv
#WomenInGI #ERCP #RadiationSafety #Endoscopy #GastroTwitter

@PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @BASLedu @BSGtrainees @WorldGastroOrg @ulstergastro @SEEDendoscopia @EASLedu @AmCollegeGastro @Aegastro @SAGES_updates @UHSEndoscopy @WAGE_media @ESGE_news @my_ueg

[Stuart Mcpherson @stumcp]

Hepatocellular carcinoma surveillance: minimum standards https://t.co/T0dfxvq1dO

[Frontline Gastro @FrontGastro_BMJ]

Calling all ERCP endoscopists! Check out this paper on the use of Needle knife fistulotomy (NKF) in the setting of difficult cannulation, published in the journal.

✅ NKF is an effective method for achieving biliary cannulation in difficult cases on initial attempt (88.5%) and repeat attempt (92.7%), with low risks of pancreatitis (2.4%), bleeding (0.3%) and perforation (0.3%).
📈 Factors associated with higher success and lower complications included ERCP performed for stone disease and Haraldsson type 3 papillae.
⚠️ NKF should be considered early in ERCP where there is difficulty in achieving biliary cannulation, especially where there are favourable characteristics.

https://t.co/JAK9qBCr8S

With thanks to the authors: Wai Liam Lam (@bluewailiam), Michael Ding, Chia Chuin Yau, Roderik Prawiradiradja and Srisha Hebbar (@Srisha_Hebbar).

@PhilSmithIsBack @OTavabie @dr_aditi_kumar @DrJMKennedy @DunnePdj @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @drkeithsiau @DrOmerAhmad @Dunnepdj @shraddha_gulati @CardiffGastro @DrBuHayee @poodocnisha @Sharm_Sub

#ERCP #BiliaryEndoscopy #Pancreatobiliary #HPB #BileDuct #Sphincterotomy #TherapeuticEndoscopy #AdvancedEndoscopy #GIEndoscopy #EndoTwitter

[Frontline Gastro @FrontGastro_BMJ]

🚨 Characteristics, aetiology and outcomes in patients with and without HCC 🚨

Insights from 🏴‍☠️ @AdrianStanleyGI in @FrontGastro_BMJ —
🔹 21.6% of HCC patients had no cirrhosis - diagnosed older & with more advanced disease.
🔹 No survival difference between cirrhotic & non-cirrhotic patients, but TACE outcomes were better for non-cirrhotic.

Full paper here – https://t.co/xuX0PJXma4

#HCC #Cirrhosis #LiverCancer #MedicalResearch #CancerCare #Hepatology
@BASLedu @BritSocGastro @EASLnews @EASLedu @AASLDtweets @PhilSmithIsBack @dr_aditi_kumar @OTavabie @DrJMKennedy @DunnePdj @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

Just out! Important #onlinefirst #openaccess #originalresearch from @NeilRajJ1 @NadirAbbas_X @DasariVm and colleagues on liver transplant assessment for HCC:

https://t.co/pnlgBOK7ix

Insights into factors affecting listing, five year survival and downstaging pathway.

#livertwitter @sheiybani @PhilSmithIsBack @DrJMKennedy @DunnePdj @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

We are delighted to announce that Frontline Gastroenterology (FG) is now the official journal partner of the British Association for Study of Liver Disease (BASL, @basl_events)

Our Editor in chief @PhilSmithIsBack is pictured with BASL President Dr Tim Cross @ClinicLiver to mark the official affiliation

Read the full statements here via:

https://t.co/cS394gN4w9

https://t.co/Xip7xDmIfD

#LiverDisease @BAPENUK @BSPGHAN @BritSocGastro @acv69cardenas @DrLChina @GeriKeane @jamesbmaurice @drobeirne @NEndoscopy @DunnePdj @sheiybani @Gut_BMJ @BMJOpen_Gastro @BASLedu

[Philip Dunne @DunnePdj]

3 year f-u data from our pTIPSS RCT. Reduced 3-year survival in pTIPSS arm with assoc higher rates of sepsis events. Unclear if TIPSS causing (GI blood bypassing Kuppfer cells of liver), carvedilol preventing, or both. Needs further study, pt selection for pTIPSS critical

[Frontline Gastro @FrontGastro_BMJ]

Long term follow up of patients from an RCT of standard of care vs pre-emptive TIPSS following acute variceal UGIB showed ⬇️ 3 year transplant-free survival.

👉 https://t.co/nlWaerWIAg 👈

Read our latest #onlinefirst article from @DunnePdj @AdrianStanleyGI @shamsaman @EwanForrest1 and colleagues.

#livertwitter @PhilSmithIsBack @sheiybani @VivekGoodoory @RexWHHui @DrJMKennedy @OTavabie @dr_aditi_kumar

[Frontline Gastro @FrontGastro_BMJ]

🎉 Happy New Year from all at FG!

Kick off your 2025 with a resolution to keep up to date with all our #onlinefirst content at https://t.co/FPfOTigvL5

@PhilSmithIsBack @sheiybani
@VivekGoodoory @DunnePdj @RexWHHui @OTavabie @dr_aditi_kumar

[Frontline Gastro @FrontGastro_BMJ]

Want to become a reviewer for FG?

Register your interest HERE 👉 https://t.co/1DrW4yHyvr

Why review for us?
✅ Stay up to date
✅ Help contribute to your field
✅ Improve your own editing and writing skills

And much more!

@sheiybani @VivekGoodoory @RexWHHui @DunnePdj @DrJMKennedy @OTavabie @dr_aditi_kumar @PhilSmithIsBack

[Philip Dunne @DunnePdj]

@Sanchit30497977 @AtoosaRabiee @ebtapper @OTavabie Time is key. Primary prophylaxis study in Scotland of compensated patients: carv vs banding - reduction in decomp and death only seen in long-term follow-up, KMs start to split at around 3 yrs.

[Philip Dunne @DunnePdj]

@BlaneyMD @ebtapper @AtoosaRabiee @OTavabie Quite a fewcensored in no-carv group, why? Also would be good to know compliance and % reaching optimum dose. Was KM in slide ITT or per-protocol??

[Philip Dunne @DunnePdj]

No surprises here from the home of GMAWS. Patients with alcohol withdrawal syndrome and ArLD are managed extremely well. This paper in @FrontGastro_BMJ is very informative.

https://t.co/eKRbo4Px5O

[Frontline Gastro @FrontGastro_BMJ]

🔍 Latest original research from @EwanForrest1 and colleagues on the management of alcohol withdrawal syndrome (AWS) in patients with advanced alcohol-related liver disease (ArLD)

💡 Patients with AWS but without ArLD received greater doses of benzodiazepines than those with ArLD
💡 AWS with ArLD did not appear to confer poorer survival than ArLD without AWS
💡 Symptom triggered approach with lorazepam effective in AWS and ArLD

@sheiybani @VivekGoodoory @RexWHHui @DunnePdj @DrJMKennedy @OTavabie @dr_aditi_kumar @PhilSmithIsBack

[Philip Dunne @DunnePdj]

I sit on a NET MDT and found this quite useful

[Frontline Gastro @FrontGastro_BMJ]

All the need-to-know aspects of diagnosing and staging NETs found at endoscopy from @gastrolivuni, @DrMohidKhan and colleagues, #onlinefirst in FG: https://t.co/fB8QLEQTMT

@sheiybani @VivekGoodoory @RexWHHui @DunnePdj @DrJMKennedy @OTavabie @dr_aditi_kumar @PhilSmithIsBack

[Philip Dunne @DunnePdj]

@FrontGastro_BMJ are looking for new trainee asociate editors. My time in this role has come to end - it was such a fantastic opportunity to be involved with the inner workings of a medical journal, whilst meeting some great people along the way. Happy to chat.

[Frontline Gastro @FrontGastro_BMJ]

#FGImage from the paper by Everett et al:

"British Society of Gastroenterology Endoscopic Retrograde Cholangiopancreatography (ERCP) Quality Improvement Programme: minimum service standards and good practice statements"

https://t.co/DMQH80xdlZ

@SimonMEverett

[BSG @BritSocGastro]

Congratulations to Prof Ewan Forrest, Consultant Physician and Hepatologist at Glasgow Royal Infirmary, NHS GGC, and Honorary Professor at University of Glasgow, who is the new BSG Alcohol Lead!

Prof Forrest will act as the lead and champion for the BSG on Alcohol, Alcohol-related harm and Alcohol-related liver disease 👉 https://t.co/MsbvoMcJwx

[Philip Dunne @DunnePdj]

What a pleasure!

[Phil Smith @PhilSmithIsBack]

I am delighted to introduce the full @FrontGastro_BMJ team from across the globe - see the editorial board here:

https://t.co/SgL8RMnNpN

Please submit your research papers & reviews via the website & contact us with any ideas or suggestions:

https://t.co/XdO3KFEwW7

#TeamFG

[Philip Dunne @DunnePdj]

Our letter published in @Gut_BMJ regarding combination NSBBs and banding for primary prophylaxis variceal bleeding. Follows CAVARLY trial. Some interesting findings need confirmed.

https://t.co/H9fFMugLe1

@AdrianStanleyGI
@EwanForrest1