Routine laboratory testing before endoscopic procedures

This is a clinical update discussing the use of periendoscopic laboratory testing in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy (ASGE) prepared this document by using MEDLINE and PubMed databases to search for publications between January 1990 and December 2013 pertaining to this topic. The keywords “endoscopy” and “laboratory” were used with each of the following: “preanesthesia,” “preoperative,” “routine,” “screening,” and “testing.” The search was supplemented by accessing the “related articles” feature of PubMed with articles identified on MEDLINE and PubMed as the references. Additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When few or no data were available from well-designed prospective trials, emphasis was given to results from large series and reports from recognized experts. Weaker recommendations are indicated by phrases such as “We suggest.,” whereas stronger recommendations are stated as “We recommend..” The strength of individual recommendations was based on both the aggregate evidence quality (Table 1) and an assessment of the anticipated benefits and harms. ASGE guidelines for appropriate use of endoscopy are based on a critical review of the available data and expert consensus at the time that the documents are drafted. Further controlled clinical studies may be needed to clarify aspects of this document. This document may be revised as necessary to account for changes in technology, new data, or other aspects of clinical practice and is solely intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This document is not a rule and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions in any particular case involve a complex analysis of the patient’s condition and available courses of action. Therefore, clinical considerations may lead an endoscopist to take a course of action that varies from the recommendations and suggestions proposed in this document.