The role of ERCP in benign diseases of the biliary tract

This is one of a series of statements discussing the use of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy (ASGE) prepared this text. In preparing this guideline, a search of the medical literature was performed by using PubMed from January 1980 through December 2013 by using the keyword(s) "choledocholithiasis," "biliary stricture," "primary sclerosing cholangitis," "cholangiopathy," "sphincter of Oddi dysfunction," "biliary leak," "choledochal cyst," "choledochocele," AND "gastrointestinal endoscopy," "ERCP," "endoscopy," and "endoscopic procedures." The search was supplemented by accessing the "related articles" feature of PubMed, with articles identified on PubMed as the references. Pertinent studies published in English were reviewed. Additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data exist from well-designed projective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate use of endoscopy are based on a critical review of the available data and expert consensus at the time the guidelines are drafted. Further controlled clinical studies may be needed to clarify aspects of this guideline. This guideline may be revised as necessary to account for changes in technology, new data, or other aspects of clinical practice. The recommendations were based on reviewed studies and were graded on the strength of the supporting evidence using the GRADE criteria1 (Table 1).