Gastrointestinal Endoscopy: October 2026 (Vol. 104, Issue 4)

Uh, this document was update from similar document that ASG had put out in 2017.

So can you walk us through, uh, what are the key differences between 2017 document and the current document?

Yeah, absolutely.

Um, I mean, first off, that document is, [chuckles] is just absolutely just a, a monster, right? It's, uh, Vinay Chandrasekara, who was the, the first author.

I, I haven't checked lately, but I'm sure it's been cited, you know, well over 1,000 times.

Uh, it's beautifully written, uh, and I probably cite it on every single paper I, I write [chuckles] or, you know, in my own research on ERCP.

So, so it's just, um, just a, a joy and a huge privilege and honor to, to be able to, to update that document, um, you know, given what it's, what it's meant to, to our field.

Um, but really what we tried to do is just, uh, you know, think of just a big sort of hypothetical table in our minds.

So, uh, we wanted to try and be as modular as possible and separate out, uh, the different subtypes, if you will, of ERCP, uh, just as we know more and more about the procedure.

So we looked at, um, reporting the adverse events according to the procedure type being performed, so we looked at basically routine ERCP, which really is primarily biliary ERCP.

Um, and then the second main category was ERCP with pancreatic interventions.

The third was ERCP with either cholangioscopy or pancreatoscopy.

And then the last was, um, sort of niche subpopulations on, on whom ERCP is performed, so specifically pediatric patients, pregnant patients, um, as well as those with altered or post-surgical upper GI anatomy.

So, uh, those were kind of the main procedure subtypes.

And then within each of those, we went and, and tried to do what Vinay, um, you know, and colleagues did in 2017, which is really delve deep into each of the major ERCP adverse events.

So, uh, obviously, those are, you know, pancreatitis, which is still probably the most common and most feared adverse event, bleeding, cholangitis, cholecystitis, perforation, and then other more specific adverse events, you know, um, specific to the technique or indication being, being discussed.

Uh, so that was kind of the main framework that we used to, to inform, you know, the design of the document.

Uh, and then obviously the other, you know, key, uh, difference is just that we had close to a decade's worth of additional data just to inform our estimates as best as possible, which is why, uh, you know, our, our governing board a- as well as our panel, uh, thought that it was important to, to issue an update.