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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline
Endoscopy, Volume 54, No. 2, Year 2022
Notification
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Description
Main Recommendations 1 ESGE recommends the use of endoscopic ultrasound-guided biliary drainage (EUS-BD) over percutaneous transhepatic biliary drainage (PTBD) after failed endoscopic retrograde cholangiopancreatography (ERCP) in malignant distal biliary obstruction when local expertise is available. Strong recommendation, moderate quality evidence. 2 ESGE suggests EUS-BD with hepaticogastrostomy only for malignant inoperable hilar biliary obstruction with a dilated left hepatic duct when inadequately drained by ERCP and/or PTBD in high volume expert centers. Weak recommendation, moderate quality evidence. 3 ESGE recommends that EUS-guided pancreatic duct (PD) drainage should only be considered in symptomatic patients with an obstructed PD when retrograde endoscopic intervention fails or is not possible. Strong recommendation, low quality evidence. 4 ESGE recommends rendezvous EUS techniques over transmural PD drainage in patients with favorable anatomy owing to its lower rate of adverse events. Strong recommendation, low quality evidence. 5 ESGE recommends that, in patients at high surgical risk, EUS-guided gallbladder drainage (GBD) should be favored over percutaneous gallbladder drainage where both techniques are available, owing to the lower rates of adverse events and need for re-interventions in EUS-GBD. Strong recommendation, high quality of evidence. 6 ESGE recommends EUS-guided gastroenterostomy (EUS-GE), in an expert setting, for malignant gastric outlet obstruction, as an alternative to enteral stenting or surgery. Strong recommendation, low quality evidence. 7 ESGE recommends that EUS-GE may be considered in the management of afferent loop syndrome, especially in the setting of malignancy or in poor surgical candidates. Strong recommendation, low quality evidence. 8 ESGE suggests that endoscopic ultrasound-directed transgastric ERCP (EDGE) can be offered, in expert centers, to patients with a Roux-en-Y gastric bypass following multidisciplinary decision-making, with the aim of overcoming the invasiveness of laparoscopy-assisted ERCP and the limitations of enteroscopy-assisted ERCP. Weak recommendation, low quality evidence. © 2022 Endoscopy. All rights reserved.
Authors & Co-Authors
van der Merwe, Schalk Willem
Belgium, Leuven
Ku Leuven– University Hospital Leuven
Everett, Simon M.
United Kingdom, Leeds
Leeds Teaching Hospitals Nhs Trust
Lakhtakia, Sundeep
India, Hyderabad
Asian Institute of Gastroenterology India
Hucl, Tomáš
Czech Republic, Prague
Institutu Klinické a Experimentální Medicíny
Law, Ryan J.
United States, Rochester
Mayo Clinic
Arcidiacono, Paolo Giorgio
Italy, Milan
Irccs Ospedale San Raffaele
Larghi, Alberto
Italy, Rome
Università Cattolica Del Sacro Cuore, Campus Di Roma
Giovannini, Marc A.
France, Marseille
Institut Paoli-calmettes
Khashab, Mouen A.
United States, Baltimore
The Johns Hopkins Hospital
Barthet, Marc A.
France, Marseille
Ap-hm Assistance Publique - Hôpitaux de Marseille
Pérez-Miranda, Manuel
Spain, Valladolid
Hospital Universitario Río Hortega
Statistics
Citations: 124
Authors: 11
Affiliations: 17
Identifiers
Doi:
10.1055/a-1717-1391
ISSN:
0013726X
Research Areas
Cancer
Health System And Policy
Study Design
Randomised Control Trial