Copyright ©The Author(s) 2019.
World J Gastrointest Endosc. Mar 16, 2019; 11(3): 219-230
Published online Mar 16, 2019. doi: 10.4253/wjge.v11.i3.219
Table 1 Summary of current evidence for each topic
TopicCurrent evidence
Management of " difficult" choledocolithiasisEST plus EPLBD
CholangioscopyElectrohydraulic or laser lithotripsy/tissue sampling
Safety in ERCP: complications and infections
PEPRectal administration of 100 mg of diclofenac or indomethacin and pancreatic duct stenting in high-risk and average-risk patients/aggressive intravenous hydration/wire-guided cannulation
Multi-drug resistant bacteria and duodenoscopesSingle-use disposable elevator
Management of malignant and benign biliary stricturesBilateral drainage for hilar strictures with uSEMS /“multi-stenting” treatment for benign biliary strictures
Tissue ablation techniquesPDT with biliary stenting in advanced cholangiocarcinoma (more studies are needed)
RFA for advanced cholangiocarcinoma (more studies are needed)
Training in biliopancreatic endoscopyERCP: at least 200 procedures under supervision of a tutor with 80 sphincterotomies and 60 stent insertions
EUS: at least 225 hands-on cases under supervision
Biodegradable and drug-coated stentsBDBSs with polylactide or polydioxanone showed good biocompatibility (more studies are needed)
Only paclitaxel has been trialed in humans with malignant obstruction (more studies are needed)
Sedation in ERCPPropofol and standard sedation by non-anesthesiologists is equivalent in terms of efficacy and safety in a setting of properly trained staff and accurate patient selection (ASGE): ESA retracted its endorsement to ESGE and ESGENA