ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis

ASGE STANDARDS OF PRACTICE COMMITTEE

Research output: Contribution to journalArticle

Abstract

Each year choledocholithiasis results in biliary obstruction, cholangitis, and pancreatitis in a significant number of patients. The primary treatment, ERCP, is minimally invasive but associated with adverse events in 6% to 15%. This American Society for Gastrointestinal Endoscopy (ASGE) Standard of Practice (SOP) Guideline provides evidence-based recommendations for the endoscopic evaluation and treatment of choledocholithiasis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to rigorously review and synthesize the contemporary literature regarding the following topics: EUS versus MRCP for diagnosis, the role of early ERCP in gallstone pancreatitis, endoscopic papillary dilation after sphincterotomy versus sphincterotomy alone for large bile duct stones, and impact of ERCP-guided intraductal therapy for large and difficult choledocholithiasis. Comprehensive systematic reviews were also performed to assess the following: same-admission cholecystectomy for gallstone pancreatitis, clinical predictors of choledocholithiasis, optimal timing of ERCP vis-à-vis cholecystectomy, management of Mirizzi syndrome and hepatolithiasis, and biliary stent therapy for choledocholithiasis. Core clinical questions were derived using an iterative process by the ASGE SOP Committee. This body developed all recommendations founded on the certainty of the evidence, balance of risks and harms, consideration of stakeholder preferences, resource utilization, and cost-effectiveness.

Original languageEnglish (US)
Pages (from-to)1075-1105.e15
JournalGastrointestinal endoscopy
Volume89
Issue number6
DOIs
StatePublished - Jun 1 2019

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Choledocholithiasis
Gastrointestinal Endoscopy
Endoscopy
Endoscopic Retrograde Cholangiopancreatography
Guidelines
Pancreatitis
Cholecystectomy
Gallstones
Mirizzi Syndrome
Literature
Cholangitis
Therapeutics
Bile Ducts
Practice Guidelines
Cost-Benefit Analysis
Stents
Dilatation

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis. / ASGE STANDARDS OF PRACTICE COMMITTEE.

In: Gastrointestinal endoscopy, Vol. 89, No. 6, 01.06.2019, p. 1075-1105.e15.

Research output: Contribution to journalArticle

ASGE STANDARDS OF PRACTICE COMMITTEE. / ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis. In: Gastrointestinal endoscopy. 2019 ; Vol. 89, No. 6. pp. 1075-1105.e15.
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abstract = "Each year choledocholithiasis results in biliary obstruction, cholangitis, and pancreatitis in a significant number of patients. The primary treatment, ERCP, is minimally invasive but associated with adverse events in 6{\%} to 15{\%}. This American Society for Gastrointestinal Endoscopy (ASGE) Standard of Practice (SOP) Guideline provides evidence-based recommendations for the endoscopic evaluation and treatment of choledocholithiasis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to rigorously review and synthesize the contemporary literature regarding the following topics: EUS versus MRCP for diagnosis, the role of early ERCP in gallstone pancreatitis, endoscopic papillary dilation after sphincterotomy versus sphincterotomy alone for large bile duct stones, and impact of ERCP-guided intraductal therapy for large and difficult choledocholithiasis. Comprehensive systematic reviews were also performed to assess the following: same-admission cholecystectomy for gallstone pancreatitis, clinical predictors of choledocholithiasis, optimal timing of ERCP vis-{\`a}-vis cholecystectomy, management of Mirizzi syndrome and hepatolithiasis, and biliary stent therapy for choledocholithiasis. Core clinical questions were derived using an iterative process by the ASGE SOP Committee. This body developed all recommendations founded on the certainty of the evidence, balance of risks and harms, consideration of stakeholder preferences, resource utilization, and cost-effectiveness.",
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