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ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.

Abstract：

PROPHYLAXIS:1: ESGE recommends routine rectal administration of 100 mg of diclofenac or indomethacin immediately before endoscopic retrograde cholangiopancreatography (ERCP) in all patients without contraindications to nonsteroidal anti-inflammatory drug administration.Strong recommendation, moderate quality evidence. 2: ESGE recommends prophylactic pancreatic stenting in selected patients at high risk for post-ERCP pancreatitis (inadvertent guidewire insertion/opacification of the pancreatic duct, double-guidewire cannulation).Strong recommendation, moderate quality evidence. 3: ESGE suggests against routine endoscopic biliary sphincterotomy before the insertion of a single plastic stent or an uncovered/partially covered self-expandable metal stent for relief of biliary obstruction.Weak recommendation, moderate quality evidence. 4: ESGE recommends against the routine use of antibiotic prophylaxis before ERCP.Strong recommendation, moderate quality evidence. 5: ESGE suggests antibiotic prophylaxis before ERCP in the case of anticipated incomplete biliary drainage, for severely immunocompromised patients, and when performing cholangioscopy.Weak recommendation, moderate quality evidence. 6: ESGE suggests tests of coagulation are not routinely required prior to ERCP for patients who are not on anticoagulants and not jaundiced.Weak recommendation, low quality evidence. TREATMENT:7: ESGE suggests against salvage pancreatic stenting in patients with post-ERCP pancreatitis.Weak recommendation, low quality evidence. 8: ESGE suggests temporary placement of a biliary fully covered self-expandable metal stent for post-sphincterotomy bleeding refractory to standard hemostatic modalities.Weak recommendation, low quality evidence. 9: ESGE suggests to evaluate patients with post-ERCP cholangitis by abdominal ultrasonography or computed tomography (CT) scan and, in the absence of improvement with conservative therapy, to consider repeat ERCP. A bile sample should be collected for microbiological examination during repeat ERCP.Weak recommendation, low quality evidence.

journal_name

Endoscopy

journal_title

Endoscopy

authors

Dumonceau JM,Kapral C,Aabakken L,Papanikolaou IS,Tringali A,Vanbiervliet G,Beyna T,Dinis-Ribeiro M,Hritz I,Mariani A,Paspatis G,Radaelli F,Lakhtakia S,Veitch AM,van Hooft JE

doi

10.1055/a-1075-4080

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

127-149

issue

eissn

0013-726X

issn

1438-8812

journal_volume

pub_type

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ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.