ASGE guideline on the management of cholangitis - 13/07/21

Doi : 10.1016/j.gie.2020.12.032

Prepared by: ASGE STANDARDS OF PRACTICE COMMITTEEJames L. Buxbaum, MD, FASGE ¹, Carlos Buitrago, MD ¹, Alice Lee, MD ¹, Badih Joseph Elmunzer, MD ², Ahsun Riaz, MD ³, Eugene P. Ceppa, MD, FACS ⁴, Mohammed Al-Haddad, MD, FASGE ⁵, Stuart K. Amateau, MD, PhD, FASGE ⁶, Audrey H. Calderwood, MD, MS, FASGE ⁷, Douglas S. Fishman, MD, FAAP, FASGE ⁸, Larissa L. Fujii-Lau, MD ⁹, Laith H. Jamil, MD, FASGE ¹⁰, Terry L. Jue, MD, FASGE ¹¹, Richard S. Kwon, MD ¹², Joanna K. Law, MD, FASGE ¹³, Jeffrey K. Lee, MD, MPH ¹⁴, Mariam Naveed, MD ¹⁵, Swati Pawa, MD, FASGE ¹⁶, Mandeep S. Sawhney, MD, MS, FASGE ¹⁷, Hannah Schilperoort, MLIS, MA ¹, Andrew C. Storm, MD ¹⁸, Nirav C. Thosani, MD ¹⁹, Bashar J. Qumseya, MD, MPH, FASGE ^20,^⁎ : (ASGE Standards of Practice Committee Chair), Sachin Wani, MD, FASGE ²¹ : (previous Committee Chair, 2017-2020)
¹ Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
² Department of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina, USA
³ Department of Vascular and Interventional Radiology, Northwestern Medicine, Chicago, Illinois, USA
⁴ Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
⁵ Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
⁶ Division of Gastroenterology Hepatology and Nutrition, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
⁷ Department of Gastroenterology and Hepatology, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
⁸ Section of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
⁹ Department of Gastroenterology, The Queen’s Medical Center, Honolulu, Hawaii, USA
¹⁰ Section of Gastroenterology and Hepatology, Beaumont Health, Royal Oak, Michigan, USA, Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
¹¹ Department of Gastroenterology, The Permanente Medical Group, San Francisco, California, USA
¹² Department of Gastroenterology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
¹³ Department of Gastroenterology and Hepatology, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington, USA
¹⁴ Department of Gastroenterology, Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA
¹⁵ Advent Health Medical Group, Department of Gastroenterology/Hepatology, Advent Health Hospital Altamonte Springs, Altamonte Springs, Florida, USA
¹⁶ Department of Gastroenterology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
¹⁷ Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
¹⁸ Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
¹⁹ Division of Gastroenterology, Hepatology and Nutrition, McGovern Medical School, UTHealth, Houston, Texas, USA
²⁰ Department of Gastroenterology, University of Florida, Gainesville, Florida, USA
²¹ Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA

^∗Reprint requests: Bashar J. Qumseya, MD, MPH, FASGE, Associate Professor of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL 32608.Associate Professor of MedicineDivision of GastroenterologyHepatology, and Nutrition, University of FloridaGainesvilleFL32608

Abstract

Cholangitis is a GI emergency requiring prompt recognition and treatment. The purpose of this document from the American Society for Gastrointestinal Endoscopy’s (ASGE) Standards of Practice Committee is to provide an evidence-based approach for management of cholangitis. This document addresses the modality of drainage (endoscopic vs percutaneous), timing of intervention (<48 hours vs >48 hours), and extent of initial intervention (comprehensive therapy vs decompression alone). Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to formulate recommendations on these topics. The ASGE suggests endoscopic rather than percutaneous drainage and biliary decompression within 48 hours. Additionally, the panel suggests that sphincterotomy and stone removal be combined with drainage rather than decompression alone, unless patients are too unstable to tolerate more extensive endoscopic treatment.

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Abbreviations : ASGE, CI, GRADE, NIS, OR, PICO, PTBD, SOP

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This document was reviewed and approved by the Governing Board of the American Society for Gastrointestinal Endoscopy.

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Vol 94 - N° 2

P. 207 - août 2021 Retour au numéro

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ASGE guideline on the role of endoscopy in the management of malignant hilar obstruction
Bashar J. Qumseya, Laith H. Jamil, Badih Joseph Elmunzer, Ahsun Riaz, Eugene P. Ceppa, Nirav C. Thosani, James L. Buxbaum, Andrew C. Storm, Mandeep S. Sawhney, Swati Pawa, Mariam Naveed, Jeffrey K. Lee, Joanna K. Law, Richard S. Kwon, Terry L. Jue, Larissa L. Fujii-Lau, Douglas S. Fishman, Audrey H. Calderwood, Stuart K. Amateau, Mohammed Al-Haddad, Sachin Wani

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ASGE guideline on the management of cholangitis - 13/07/21

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