ASGE Guidelines


ASGE evidence-based guidelines provide clinicians with recommendations for the evaluation, diagnosis, and management of patients undergoing endoscopic procedures of the digestive tract. Guidelines are not a substitute for physicians’ opinion on individual patients. Final decision on an intervention should always be based on local expertise and patient preferences.

All recommendations follow a rigorous process based on a systematic review of medical literature as outlined by the National Academy of Medicine (formerly Institute of Medicine) standards for guideline development.

Whenever possible, guidelines are based on the GRADE (Grading of Recommendation Assessment, Development and Evaluation) methodology.

Panels consist of content experts, stakeholders from other specialties, patient representatives, and members of the ASGE Standards of Practice (SOP) Committee.

Each recommendation is based on consideration of the best medical literature, the balance between risks and benefits, cost-effectiveness, patients’ values, and equity.

Panel members provide ongoing conflict of interest (COI) disclosures, including intellectual conflicts of interest, throughout the development and publication of all guidelines in accordance with the ASGE Policy for Managing Declared Conflicts of Interests.

ASGE strives to provide clinically relevant and practical recommendations, which can help standardize patient care and improve outcomes.

If you have any questions or suggestions, please contact Customer Support at Info@asge.org.

The following information is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. It is very important that you consult your doctor about your specific condition.

Newly Published
GRADE Guidelines
Upper GI
Lower GI
Biliary and Pancreatic Endoscopy

ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis

Jul 1, 2019, 16:01 PM
Each year choledocholithiasis results in biliary obstruction, cholangitis, and pancreatitis in a significant number of patients. The primary treatment, ERCP, is minimally invasive but associated with adverse events in 6% to 15%. This American Society for Gastrointestinal Endoscopy (ASGE) Standard of Practice (SOP) Guideline provides evidence-based recommendations for the endoscopic evaluation and treatment of choledocholithiasis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to rigorously review and synthesize the contemporary literature regarding the following topics: EUS versus MRCP for diagnosis, the role of early ERCP in gallstone pancreatitis, endoscopic papillary dilation after sphincterotomy versus sphincterotomy alone for large bile duct stones, and impact of ERCP-guided intraductal therapy for large and difficult choledocholithiasis. Comprehensive systematic reviews were also performed to assess the following: same-admission cholecystectomy for gallstone pancreatitis, clinical predictors of choledocholithiasis, optimal timing of ERCP vis-à-vis cholecystectomy, management of Mirizzi syndrome and hepatolithiasis, and biliary stent therapy for choledocholithiasis. Core clinical questions were derived using an iterative process by the ASGE SOP Committee. This body developed all recommendations founded on the certainty of the evidence, balance of risks and harms, consideration of stakeholder preferences, resource utilization, and cost-effectiveness.
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)
Title : ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis
Doi org link : https://doi.org/10.1016/j.gie.2018.10.001
Volume : Gastrointest Endosc 2019; Volume 89, Issue 6; P1075-1105.E15
URL :
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Content created : Apr 9, 2019, 00:00 AM
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Categories :
  • ERCP/Cholangioscopy
Tags :
  • Bile Duct
  • ERCP
  • EUS
Adverse Events
Privileging and Credentialing
GI Endoscopy Unit Operations
Screening and Surveillance in Premalignant Conditions
Procedural Management in Endoscopy
Miscellaneous
Guidelines in Spanish

In Progress Guidelines

ASGE Guideline on management of code status in the periendoscopic period

Estimated 2025

Quality in Endoscopy

Quality documents define the indicators of high-quality endoscopy and how to measure it. ASGE quality indicators are based on a rigorous review process which results in valid metrics for evaluating GI endoscopic procedures.

Quality in Endoscopy

Public Comment

ASGE guidelines approaching publication are available on the website for 30 days for public comment. All reviewers are required to submit a conflict-of-interest disclosure and acknowledge a non-disclosure agreement for the guideline draft. All comments will be reviewed by the SOP Committee. Revisions to the draft are at the discretion of the lead authors and the SOP Committee.

ASGE Guideline on endoscopic management of benign and malignant colonic strictures

Comment

Endoscopic treatment for the management of complications post bariatric surgery: European Society of Gastrointestinal Endoscopy and American Society of Gastrointestinal Endoscopy position statement

Comment