ASGE guideline on the management of cholangitis

James L. Buxbaum, Carlos Buitrago, Alice Lee, Badih Joseph Elmunzer, Ahsun Riaz, Eugene P. Ceppa, Mohammed Al-Haddad, Stuart K. Amateau, Audrey H. Calderwood, Douglas S. Fishman, Larissa L. Fujii-Lau, Laith H. Jamil, Terry L. Jue, Richard S. Kwon, Joanna K. Law, Jeffrey K. Lee, Mariam Naveed, Swati Pawa, Mandeep S. Sawhney, Hannah SchilperoortAndrew C. Storm, Nirav C. Thosani, Bashar J. Qumseya*, Sachin Wani

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)207-221.e14
JournalGastrointestinal endoscopy
Volume94
Issue number2
DOIs
StatePublished - Aug 2021
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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