Prospective assessment of the accuracy of ASGE and ESGE guidelines for choledocholithiasis

Abstract Background and study aims American Society of Gastrointestinal Endoscopy (ASGE) European (ESGE) guidelines recommend categorizing patients by risk for choledocholithiasis to determine management. The goal our was compare the accuracy criteria proposed in these guidelines. Patients methods All with suspected at institution were prospectively identified. Based upon initial test results, categorized as low, intermediate, high per ASGE 2010 2019, ESGE criteria. followed until 30 days post-discharge. Results endoscopic retrograde cholangiography (ERCP), ultrasound, magnetic resonance cholangiopancreatography used standard choledocholithiasis. each criterion computed. During period, 359 consecutive identified, whom 225 had Median patient age 69 years 55.3% women. 47.9% high-risk, lower than (62.7%, P<0.01), 2019 (54.6%, P=0.07). In high-risk patients, noted 83.1% criteria, similar (81.6%, P=0.7) (79.1%, P=0.3). percentage who underwent unnecessary ERCP 8.1% (13.1%, P=0.03), but (10%, P=0.4). No difference among three 30-day readmissions low-risk category. Conclusions have diagnosis However, result more needing additional testing, also a smaller proportion undergoing ERCP.