Common bile duct stones are not removable in 10-15% of the cases with the traditional dormia basket or extraction balloon methods due to the size, shape of stone, or the anatomy of the bile duct, localization of biliary stone. Effective modalities are in these cases the papillary large balloon dilatation, the mechanical lithotripsy, the cholangioscopy assisted electrohydraulic or laser lithotripsy, and the extracorporeal shock­wave lithotripsy. Endoscopic management of difficult bile duct stones, the applicability and the efficacy of these less frequently used modalities are summarized.

The prevalence of extraintestinal manifestations of chronic non-specific intestinal inflammatory disorders is around 30%. They may appear before, in parallel or after the diagnosis of IBD and have major impact on patients’ quality of life. Practically any organ can be affected, but joint, skin, hepatobiliary and eye manifestations are the most frequent. A key to successful treatment is a systematic and multidisciplinary approach.

Percutaneous endoscopic gastrostomy (PEG) is a worldwide accepted procedure of artificial enteral nutrition for patients who are unable to eat the required amount in the long run. However due to the fact that it is a safe and easy technique it might lead to use with inappropriate indications and with questionable timing. Due to PEG we know more about artificial enteral nutrition, and our mindset about indications changed as well. This publication gives any overview of the procedure and its clinical usage in light of the three decades of experience that we have.

The non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder worldwide, a clinicopa­thological spectrum from pure steatosis to steatohepatitis and cirrhosis. The progressive form of NAFLD is the non-alcoholic steatohepatitis (NASH) with or without fibrosis has a high risk of severe outcomes, including hepatic and extrahepatic complications. The diagnosis of NAFLD has been based on the presence of fatty liver and lack of excessive alcohol consumption and the exclusion of other causes of steatosis. Since the term NAFLD contains „negative criteria” (and alcohol in its name), during the last two decades several authors have suggested to rename the disease to a „positive” term, that should involve metabolic instead of non-alcoholic. In 2020 an international expert consensus statement has recommended a new definition of metabolic (dysfunction)-associated fatty liver disease (MAFLD) to replace NAFLD, and it was suggested how the disease should be diagnosed. The diagnosis of MAFLD should be based on the evidence of hepatic steatosis (by imaging techniques, biomarkers or biopsy), in addition to one of the following three criteria: overweight/obesity, type 2 diabetes mellitus, and metabolic dysfunction. The proposal has evoked intensive debates in the hepatology literature. A number of experts and liver societies have been supportive concerning the usefulness of the new diagnostic criteria. It was emphasized that MAFLD can help to identify those patients with steatosis who are at high risk of more advanced liver disease, in addition, the new name mirrors the metabolic nature of the disease, and is not stigmatizing. Others dis­agreed with the change, saying that it is premature, and can create rather confusion than advance in the field. This paper gives an account on the diagnostic criteria of MAFLD, overviews the experts’ opinions on MAFLD term, and discusses the implications of the name change. It can be concluded, that the debate is not over. There is a need for further researches on better understanding of the pathogenesis of the disease entity, and continue the exchange of ideas, assess the consequences of the new terminology, thus archive a true, evidence-based consensus.