American Society for Gastrointestinal Endoscopy guideline on management of post–liver transplant biliary strictures: summary and recommendations

(ASGE Standards of Practice Committee Chair)

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

This clinical practice guideline from the American Society for Gastrointestinal Endoscopy provides an evidence-based approach for strategies to manage biliary strictures in liver transplant recipients. This document was developed using the Grading of Recommendations Assessment, Development and Evaluation framework. The guideline addresses the role of ERCP versus percutaneous transhepatic biliary drainage and covered self-expandable metal stents (cSEMSs) versus multiple plastic stents for therapy of post-transplant strictures, use of MRCP for diagnosing post-transplant biliary strictures, and administration of antibiotics versus no antibiotics during ERCP. In patients with post-transplant biliary strictures, we suggest ERCP as the initial intervention and cSEMSs as the preferred stent for extrahepatic strictures. In patients with unclear diagnoses or intermediate probability of a stricture, we suggest MRCP as the diagnostic modality. We suggest that antibiotics should be administered during ERCP when biliary drainage cannot be ensured.

Original languageEnglish (US)
Pages (from-to)607-614
Number of pages8
JournalGastrointestinal endoscopy
Volume97
Issue number4
DOIs
StatePublished - Apr 2023

Bibliographical note

Funding Information:
We thank Tracy Thomas, a patient representative from the National Organization for Transplant Enlightenment , for participating in our panel and Robyn Rosasco (librarian) for assistance with searching for articles. We are also grateful to Dr Tiffany Chua, Dr Dennis Yang, and Dr Jonathan Cohen for their review of this document. This guideline was funded exclusively by the American Society for Gastrointestinal Endoscopy; no outside funding was received to support the development of this guideline.

Funding Information:
The following authors disclosed financial relationships: D. R. Kohli: Grant support from Olympus Corporation of the Americas. S. K. Amateau: Consultant for Olympus America Inc, Cook Medical LLC , Boston Scientific Corporation , Endo-Therapeutics , Hemostasis LLC , Heraeus Medical Components , LLC, Merit Medical Systems Inc, Steris Corporation, and Taewoong Medical; travel compensation from Olympus America Inc and Cook Medical LLC; food and beverage compensation from Olympus America Inc and Boston Scientific Corporation. N. Coelho-Prabhu: Consultant for Boston Scientific Corporation. S. E. Elhanafi: Travel compensation from Endogastric Solutions and Boston Scientific Corporation; food and beverage compensation from Endogastric Solutions, Boston Scientific Corporation, Merit Medical Systems, Inc, Salix Pharmaceuticals, and Intercept Pharmaceuticals. N. Forbes: Consultant and speaker for Boston Scientific Corporation and Pentax of America, Inc; research support from Pentax of America, Inc. L. L. Fujii-Lau: Food and beverage compensation from Pfizer Inc and AbbVie Inc. R. S. Kwon: Research support from AbbVie, Inc. J. D. Machicado: Speaker for Mauna Kea Technologies, Inc; food and beverage compensation from Abbott Laboratories. N. B. Marya: Consultant for and food and beverage compensation from Boston Scientific Corporation. W. Ruan: Grant support from Pfizer, Inc. S. G. Sheth: Food and beverage compensation from Takeda Pharmaceuticals USA, Inc. N. R. Thiruvengadam: Grant support from Boston Scientific Corporation. N. C. Thosani: Consultant for Boston Scientific Corporation, Covidien LP, and Pentax of America, Inc; travel compensation from Boston Scientific Corporation; food and beverage compensation from Boston Scientific Corporation, Covidien LP, Pentax of America, Inc, Erbe USA, Inc, and Ambu Inc; speaker for AbbVie Inc. B. J. Qumseya: Food and beverage compensation from Olympus America Inc. All other authors disclosed no financial relationships.

Publisher Copyright:
© 2022 American Society for Gastrointestinal Endoscopy

PubMed: MeSH publication types

  • Practice Guideline
  • Journal Article
  • Comment

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