Current approaches and questions yet to be resolved for the prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis

doi:10.4253/wjge.v14.i11.657

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World Journal of Gastrointestinal Endoscopy

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World J Gastrointest Endosc. Nov 16, 2022; 14(11): 657-666
Published online Nov 16, 2022. doi: 10.4253/wjge.v14.i11.657

Table 2 Recommended strategies for suspected common bile duct stones in patients with symptomatic cholelithiasis based on the ESGE and ASGE guidelines

ESGE guideline			ASGE guideline
Likelihood	Predictors	Recommended strategy	Predictors	Recommended strategy
Low	Normal liver function tests and no CBD dilation at US	Proceed to cholecystectomy	No predictors	Cholecystectomy with/without laparoscopic cholangiography (IOC) or intraoperative US
Intermediate	Abnormal liver function tests and/or dilated CBD on US	Perform EUS/MRCP	Abnormal liver function tests or age > 55 years or dilated CBD on US/cross-sectional imaging	Perform EUS/MRCP, laparoscopic IOC, or intraoperative US
High	CBDSs identified at US or features of cholangitis	Proceed to ERCP	CBDSs identified at US/cross-sectional imaging	Proceed to ERCP
High	CBDSs identified at US or features of cholangitis	Proceed to ERCP	or features of cholangitis or dilated CBD with total bilirubin > 4 mg/dL on US/cross-sectional imaging	Proceed to ERCP

ASGE: American Society for Gastrointestinal Endoscopy; CBD: Common bile duct; CBDSs: Common bile duct stones; ERCP: Endoscopic retrograde cholangiopancreatography; ESGE: European Society of Gastrointestinal Endoscopy; EUS: Endoscopic ultrasonography; MRCP: Magnetic resonance cholangiopancreatography; US: Ultrasonography.

Citation: Saito H, Fujimoto A, Oomoto K, Kadowaki Y, Tada S. Current approaches and questions yet to be resolved for the prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis. World J Gastrointest Endosc 2022; 14(11): 657-666
URL: https://www.wjgnet.com/1948-5190/full/v14/i11/657.htm
DOI: https://dx.doi.org/10.4253/wjge.v14.i11.657