Gastrointest Endosc. 0000007883 00000 n Serial biochemical testing by using high . Given the wide range of specifics in any health care problem, the surgeon must always choose the course best suited to the individual patient and the variables in existence at the moment of decision. Guidelines for clinical practice are intended to indicate preferable approaches to medical problems as established by experts in the field. Laparoscopic cholecystectomy in super elderly (>90years of age): safety and outcomes. et al. Federal government websites often end in .gov or .mil. Am J Gastroenterol. ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis . 0000011146 00000 n Panels consist of content experts, stakeholders from other specialties, patient representatives, and members of the ASGE Standards of Practice (SOP) Committee. The content in this bundle consists of some of the best GIE articles and video clips related to best practices and recommended guidelines. Following biliary clearance with ERCP, it is generally recommended to proceed with subsequent cholecystectomy to prevent the occurrence of recurrent episodes of symptomatic cholelithiasis which occurs in approximately 20% of patients. Numerous factors have been implicated as prognostic predictors to help stratify patients into low, intermediate and high probability of choledocholithiasis. Please enable it to take advantage of the complete set of features! Phone: (630) 573-0600 | Fax: (630) 963-8332 | Email: info@asge.org U01 DK108334/DK/NIDDK NIH HHS/United States. eCollection 2023 Apr. ASGE,, MeSH ASGE Standards of Practice Committee, James L. Buxbaum, MD, FASGE, Syed M. Abbas Fehmi, MD, MSc, FASGE, Shahnaz Sultan, MD, MHSc, Douglas S. Fishman, MD, FAAP, FASGE, Bashar J. Qumseya, MD, MPH, Victoria K. Cortessis, PhD, Hannah Schilperoort, MLIS, MA, Lynn Kysh, MLIS, Lea Matsuoka, MD, FACS, Patrick Yachimski, MD, MPH, FASGE, AGAF, Deepak Agrawal, MD, MPH, MBA, Suryakanth R. Gurudu, MD, FASGE, Laith H. Jamil, MD, FASGE, Terry L. Jue, MD, FASGE, Mouen A. Khashab, MD, Joanna K. Law, MD, Jeffrey K. Lee, MD, MAS, Mariam Naveed, MD, Mandeep S. Sawhney, MD, MS, FASGE, Nirav Thosani, MD, Julie Yang, MD, FASGE, Sachin B. Wani, MD, FASGE (ASGE Standards of Practice Committee Chair), Rent Institute for Training and Technology, ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis, https://doi.org/10.1016/j.gie.2018.10.001, Gastrointest Endosc June 2019, Volume 89, Issue 6, Pages 10751105.e15, /docs/default-source/guidelines/asge-guideline-on-the-role-of-endoscopy-in-the-evaluation-and-management-of-choledocholithiasis-2019-june-gie.pdf?Status=Master&sfvrsn=2, ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis 2019 June GIE. Wang L, Mirzaie S, Dunnsiri T, Chen F, Wilhalme H, MacQueen IT, Cryer H, Eastoak-Siletz A, Guan M, Cuff C, Tabibian JH. The following information is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. 2019 Oct;33(10):3300-3313. doi: 10.1007/s00464-018-06620-x. Br J Surg 78:14481450, Cipolletta L, Coastamagna G, Bianco MA, Rotondano G, Piscopo R, Mutignani M, Marmo R (1997) Endoscopic mechanical lithotripsy of difficult common bile duct stones. ASGE guidelines in patients with AGP. Cochrane Database Syst Rev 12:1126, Urbach DR, Khajanchee YS, Jobe BA, Standage BA, Hansen PD, Swanstrom L (2001) Cost-effective management of common bile duct stones: a decision analysis of the use of endoscopic retrograde cholangiopancreatography (ERCP), intra-operative cholangiography, and laparoscopic bile duct exploration. Several studies have scrutinized the accuracy of the ASGE-SAGES guidelines at predicting choledocholithiasis; however, they are often based on single-center, retrospective data. The ASGE has updated its 2011 guideline on the evaluation and management of patients with choledocholithiasis. If you have any questions or suggestions, please contact Customer Support at Info@asge.org. A Cochrane review on the topic has shown that single-stage laparoscopic common bile duct exploration with cholecystectomy and two-stage ERCP followed by laparoscopic cholecystectomy have similar efficacy rates in clearing the CBD with no significant difference in patient morbidity and mortality [17]. 8600 Rockville Pike 0000004427 00000 n The subtleties in the management of common bile duct stones relate to the decision making on the probability of choledocholithiasis based on clinical presentation and investigations, the timing of presentation in relation to laparoscopic cholecystectomy in addition to the availability of technology and expertise of the surgeons, endoscopists and interventional radiologists. 0000010469 00000 n As such, the EDGE procedure can be an alternative method of accessing the biliary tree in which an anastomosis is created typically with a lumen-apposing metal stent between the gastric pouch or jejunum to the excluded stomach under endoscopic ultrasound visualization which allows a duodenoscope to be passed to perform a conventional ERCP [35] (Fig. Reasons for failure include large or impacted stones, duodenal diverticula, altered gastric or duodenal anatomy and intrahepatic stones. 2021 Mar;54(2):147-148. doi: 10.5946/ce.2021.080. are limited, available studies indicate that 21% Gastrointest Endosc 86:986993, Gurusamy KS, Giljaca V, Takwoingi Y, Higgie D, Poropat G, timac D, Davidson BR (2015) Ultrasound versus liver function tests for diagnosis of common bile duct stones. Privacy Policy | Terms of Use The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to rigorously review and synthesize the . However, in patients with advanced comorbidities who are at significantly high risk for operative intervention, ERCP with sphincterotomy without any further subsequent intervention can also be considered definitive therapy, as there has been no statistical difference in mortality [11,12]. If these endoscopic approaches prove unsuccessful, a common bile duct exploration or PTBD with its associated percutaneous interventions can then be performed for common bile duct clearance, which have been described earlier in this document. . If the initial ductotomy made for cholangiogram is too small, the ductotomy can either be extended closer to the cystic duct-CBD junction or pneumatic cystic duct dilatation can be performed under fluoroscopy over a guidewire. 2002 Jan 14-16;19(1):1-26. The 2019 revision of the ASGE guidelines decreases the utilization of ERCP as a diagnostic modality and offers an improved risk stratification tool. ASGE quality indicators are based on a rigorous review process which results in valid metrics for evaluating GI endoscopic procedures. Federal government websites often end in .gov or .mil. Bethesda, MD 20894, Web Policies Wongkanong C, Patumanond J, Ratanachu-Ek T, Junrungsee S, Tantraworasin A. PLoS One. The excluded stomach is located endosonographically from the gastric pouch or afferent limb and accessed to deploy a lumen-apposing metal stent into the excluded gastric remnant to allow antegrade passage of a duodenoscope through the fistula where conventional ERCP can be performed to access and cannulate the ampulla and biliary tree. However, in the event of failure of endoscopic techniques or in patients with rapid deterioration and sepsis-induced organ damage, percutaneous transhepatic biliary drainage should be considered as described earlier in this review. World J Gastroenterol 16:5388-5390, Ogura T, Higuchi K (2015) Technical tips of endoscopic ultrasound-guided choledochoduodenostomy. 52(9):736-744. Among more than 10,000 ERCPs performed in a 14-hospital system over 7 years, 744 cases were randomly selected from those performed for suspected choledocholithiasis, while excluding those with a prior cholecystectomy or sphincterotomy. We also found that while the 2010 ASGE guidelines in predicting high risk for choledocholithiasis had a specificity of 75.8%, using the 2019 ASGE guidelines led to an improved specificity of 89.4%. cholangiography (IOC) at elective cholecystectomy 0000007642 00000 n Credits to BSIR and Boston Scientific for permission to use the images of the internal/external biliary drain and biliary stents. The detection of bile duct stones in suspected biliary pancreatitis: comparison of MRCP, ERCP, and intraductal US. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The choledochotomy can then be closed either primarily using absorbable 40 or 50 sutures or over a T-tube, an antegrade biliary stent or with an external biliary drain depending on the surgeons discretion and the clinical situation depending on the potential risk of post-operative CBD stricture, increased pressure within the CBD leading to bile leak or retained common bile duct stones [16]. Although data regarding the natural history of choledocholithiasis We found that 2/3 of patients in the intermediate group and 83% of patients in the high risk group followed ASGE guidelines for management of choledocholithiasis in the . in a separate ASGE practice guideline.12 This guideline The following information is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. 2023 Mar 27;85(4):659-664. doi: 10.1097/MS9.0000000000000124. See this image and copyright information in PMC. If you have any questions or suggestions, please contact Customer Support at Info@asge.org. Rent Institute for Training and Technology. It is very important that you consult your doctor about your specific condition. J Laparoendosc Adv Surg Tech A. Gallstone pancreatitis was not associated with the risk for choledocholithiasis. 0000012563 00000 n 3300 Woodcreek Dr., Downers Grove, IL 60515 patients with suspected choledocholithiasis is addressed Rent Institute for Training and Technology, ASGE guideline on post-ERCP pancreatitis prevention strategies: summary and recommendations, https://doi.org/10.1016/j.gie.2022.10.005, ASGE guideline on post-ERCP pancreatitis prevention strategies: methodology and review of evidence, https://doi.org/10.1016/j.gie.2022.09.011, Adverse events associated with EGD and EGD-related techniques, https://doi.org/10.1016/j.gie.2022.04.024, ASGE guideline on informed consent for GI endoscopic procedures, https://www.giejournal.org/article/S0016-5107(21)01759-4/fulltext, ASGE guideline on screening for pancreatic cancer in individuals with genetic susceptibility: summary and recommendations, https://doi.org/10.1016/j.gie.2021.12.001, ASGE guideline on screening for pancreatic cancer in individuals with genetic susceptibility: methodology and review of evidence, https://doi.org/10.1016/j.gie.2021.12.002, Adverse events associated with EUS and EUS-guided procedures, https://doi.org/10.1016/j.gie.2021.09.009, ASGE guideline on the management of cholangitis, https://doi.org/10.1016/j.gie.2020.12.032, ASGE guideline on the role of endoscopy in the management of malignant hilar obstruction, https://doi.org/10.1016/j.gie.2020.12.035, ASGE Guideline on the Role of Endoscopy in the Management of Benign and Malignant Gastroduodenal Obstruction, https://doi.org/10.1016/j.gie.2020.07.063, American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in familial adenomatous polyposis syndromes, https://doi.org/10.1016/j.gie.2020.01.028, ASGE guideline on minimum staffing requirements for the performance of GI endoscopy, https://doi.org/10.1016/j.gie.2019.12.002, Endoscopic Recognition and Management Strategies for Malignant Colorectal Polyps Recommendations of the US MultiSociety Task Force, https://doi.org/10.1016/j.gie.2020.09.039, Endoscopic Removal of Colorectal LesionsRecommendations by the US Multi-Society Task Force on Colorectal Cancer, https://doi.org/10.1016/j.gie.2020.01.029, Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer, https://doi.org/10.1016/j.gie.2020.01.014, American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of acute colonic pseudo-obstruction and colonic volvulus, https://doi.org/10.1016/j.gie.2019.09.007, ASGE guideline on the management of achalasia, https://doi.org/10.1016/j.gie.2019.04.231, ASGE guideline on screening and surveillance of Barretts esophagus, https://doi.org/10.1016/j.gie.2019.05.012, ASGE guideline on the role of endoscopy for bleeding from chronic radiation proctopathy, https://doi.org/10.1016/j.gie.2019.04.234, ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis, https://doi.org/10.1016/j.gie.2018.10.001, The role of endoscopy in the management of choledocholithiasis, Endoscopic eradication therapy for patients with Barretts esophagusassociated dysplasia and intramucosal cancer, https://doi.org/10.1016/j.gie.2017.10.011, http://dx.doi.org/10.1016/j.gie.2015.04.003, The role of endoscopy in the management of premalignant and malignant conditions of the stomach, http://dx.doi.org/10.1016/j.gie.2015.03.1967, The role of endoscopy in the management of GERD, http://dx.doi.org/10.1016/j.gie.2015.02.021, The role of endoscopy in the bariatric surgery patient, http://dx.doi.org/10.1016/j.gie.2014.09.044, The role of endoscopy in the evaluation and management of dysphagia, http://dx.doi.org/10.1016/j.gie.2013.07.042, The role of endoscopy in the assessment and treatment of esophageal cancer, http://dx.doi.org/10.1016/j.gie.2012.10.001, Management of ingested foreign bodies and food impactions, http://dx.doi.org/10.1016/j.gie.2010.11.010, Colorectal cancer screening: Recommendations for physicians and patients from the U.S. Multi-Society Task Force on Colorectal Cancer, http://dx.doi.org/10.1016/j.gie.2017.04.003, Recommendations on fecal immunochemical testing to screen for colorectal neoplasia: a consensus statement by the US Multi-Society Task Force on colorectal cancer, http://dx.doi.org/10.1016/j.gie.2016.09.025, The role of endoscopy in the management of suspected small-bowel bleeding, http://dx.doi.org/10.1016/j.gie.2016.06.013, Colonoscopy surveillance after colorectal cancer resection: recommendations of the US multi-society task force on colorectal cancer, http://dx.doi.org/10.1016/j.gie.2016.01.020, The role of endoscopy in inflammatory bowel disease, http://dx.doi.org/10.1016/j.gie.2014.10.030, SCENIC international consensus statement on surveillance and management of dysplasia in inflammatory bowel disease, http://dx.doi.org/10.1016/j.gie.2014.12.009, The role of deep enteroscopy in the management of small-bowel disorders, http://dx.doi.org/10.1016/j.gie.2015.06.046, The role of endoscopy in the management of constipation, http://dx.doi.org/10.1016/j.gie.2014.06.018, The role of endoscopy in the patient with lower GI bleeding, http://dx.doi.org/10.1016/j.gie.2013.10.039, The role of endoscopy in the management of patients with diarrhea, http://dx.doi.org/10.1016/j.gie.2009.11.025, The role of endoscopy in the staging and management of colorectal cancer, http://dx.doi.org/10.1016/j.gie.2013.04.163, Guidelines for colonoscopy surveillance after screening and polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer, http://dx.doi.org/10.1053/j.gastro.2012.06.001, The role of endoscopy in patients with anorectal disorders, http://dx.doi.org/10.1016/j.gie.2010.04.022, The role of endoscopy in the diagnosis and treatment of cystic pancreatic neoplasms, http://dx.doi.org/10.1016/j.gie.2016.04.014, The role of endoscopy in the diagnosis and treatment of inflammatory pancreatic fluid collections, http://dx.doi.org/10.1016/j.gie.2015.11.027, The role of endoscopy in the evaluation and management of patients with solid pancreatic neoplasia, http://dx.doi.org/10.1016/j.gie.2015.09.009, The role of endoscopy for benign pancreatic disease, http://dx.doi.org/10.1016/j.gie.2015.04.022, The role of ERCP in benign diseases of the biliary tract, http://dx.doi.org/10.1016/j.gie.2014.11.019, The role of endoscopy in the evaluation and treatment of patients with biliary neoplasia, http://dx.doi.org/10.1016/j.gie.2012.09.029, Role of EUS for the evaluation of mediastinal adenopathy, http://dx.doi.org/10.1016/j.gie.2011.03.1255, http://dx.doi.org/10.1016/j.gie.2016.06.051, http://dx.doi.org/10.1016/j.gie.2012.03.252, Guidelines for privileging, credentialing, and proctoring to perform GI endoscopy, http://dx.doi.org/10.1016/j.gie.2016.10.036, ASGE Position Statement: endoscopic bariatric therapies in clinical practice, http://dx.doi.org/10.1016/j.gie.2015.06.038, ASGE guideline for infection control during GI endoscopy, https://doi.org/10.1016/j.gie.2017.12.009, Race and ethnicity considerations in GI endoscopy, http://dx.doi.org/10.1016/j.gie.2015.06.002, http://dx.doi.org/10.1016/j.gie.2015.03.1917, The role of industry representatives in the endoscopy unit, Guidelines for safety in the gastrointestinal endoscopy unit, http://dx.doi.org/10.1016/j.gie.2013.12.015, http://dx.doi.org/10.1016/j.gie.2012.01.011, Guidelines for sedation and anesthesia in GI endoscopy, http://dx.doi.org/10.1016/j.gie.2017.07.018, Management of antithrombotic agents for patients undergoing GI endoscopy, http://dx.doi.org/10.1016/j.gie.2015.09.035, http://dx.doi.org/10.1016/j.gie.2014.09.048, http://dx.doi.org/10.1016/j.gie.2014.08.008, Optimizing adequacy of bowel cleansing for colonoscopy: Recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer, http://dx.doi.org/10.1016/j.gie.2014.08.002, Routine laboratory testing before endoscopic procedures, http://dx.doi.org/10.1016/j.gie.2014.01.019, The role of endoscopy in subepithelial lesions of the GI tract, http://dx.doi.org/10.1016/j.gie.2017.02.022, http://dx.doi.org/10.1016/j.gie.2010.10.021, The role of endoscopy in ampullary and duodenal adenomas, http://dx.doi.org/10.1016/j.gie.2015.06.027, The role of endoscopy in the management of patients with peptic ulcer disease, http://dx.doi.org/10.1016/j.gie.2009.11.026, Modifications in endoscopic practice for pediatric patients, http://dx.doi.org/10.1016/j.gie.2013.08.014, http://dx.doi.org/10.1016/j.gie.2013.04.167, Guia - Endoscopia en Mujeres Embarazadas y Lactantes, http://dx.doi.org/10.1016/j.gie.2012.02.029, Profilaxis antibitica para endoscopa gastrointestinal, Optimizacion de la adecuacion de la limpieza intestinal para la colonoscopia, El manejo de agentes antitromboticos para pacientes sometidos a endoscopia gastro intestinal (GI), Quality indicators for capsule 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