Title
American Society for Gastrointestinal Endoscopy guideline on management of post-liver transplant biliary strictures: methodology and review of evidence.
Document Type
Article
Publication Date
4-1-2023
Publication Title
Gastrointestinal endoscopy
Keywords
washington; spokane
Abstract
This clinical practice guideline from the American Society for Gastrointestinal Endoscopy provides an evidence-based approach for strategies to manage biliary strictures in liver transplant recipients. This document was developed using the Grading of Recommendations Assessment, Development and Evaluation framework. The guideline addresses the role of ERCP versus percutaneous transhepatic biliary drainage and covered self-expandable metal stents (cSEMSs) versus multiple plastic stents for therapy of strictures, use of MRCP for diagnosing post-transplant biliary strictures, and administration of antibiotics versus no antibiotics during ERCP. In patients with post-transplant biliary strictures, we suggest ERCP as the initial intervention and cSEMSs as the preferred stent. In patients with unclear diagnosis or intermediate probability of a stricture, we suggest MRCP as the diagnostic modality. We suggest that antibiotics should be administered during ERCP when biliary drainage cannot be assured.
Clinical Institute
Digestive Health
Department
Hepatology
Department
Surgery
Department
Gastroenterology
Recommended Citation
Amateau, Stuart K; Kohli, Divyanshoo R; Desai, Madhav; Chinnakotla, Srinath; Harrison, M Edwyn; Chalhoub, Jean M; Coelho-Prabhu, Nayantara; Elhanafi, Sherif E; Forbes, Nauzer; Fujii-Lau, Larissa L; Kwon, Richard S; Machicado, Jorge D; Marya, Neil B; Pawa, Swati; Ruan, Wenly; Sheth, Sunil G; Thiruvengadam, Nikhil R; Thosani, Nirav C; Qumseya, Bashar J; and Committee Chair, ASGE Standards of Practice, "American Society for Gastrointestinal Endoscopy guideline on management of post-liver transplant biliary strictures: methodology and review of evidence." (2023). Articles, Abstracts, and Reports. 7108.
https://digitalcommons.providence.org/publications/7108