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13.10.2022 | Guidelines

EAES rapid guideline: updated systematic review, network meta-analysis, CINeMA and GRADE assessment, and evidence-informed European recommendations on the management of common bile duct stones

verfasst von: Luigi Boni, Bright Huo, Laura Alberici, Claudio Ricci, Sofia Tsokani, Dimitris Mavridis, Yasser Sami Amer, Alexandros Andreou, Thomas Berriman, Gianfranco Donatelli, Nauzer Forbes, Stylianos Kapiris, Cüneyt Kayaalp, Leena Kylänpää, Pablo Parra-Membrives, Peter D. Siersema, George F. Black, Stavros A. Antoniou

Erschienen in: Surgical Endoscopy | Ausgabe 11/2022

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Abstract

Background

Choledocholithiasis presents in a considerable proportion of patients with gallbladder disease. There are several management options, including preoperative or intraoperative endoscopic cholangiopancreatography (ERCP), and laparoscopic common bile duct exploration (LCBDE).

Objective

To develop evidence-informed, interdisciplinary, European recommendations on the management of common bile duct stones in the context of intact gallbladder with a clinical decision to intervene to both the gallbladder and the common bile duct stones.

Methods

We updated a systematic review and network meta-analysis of LCBDE, preoperative, intraoperative, and postoperative ERCP. We formed evidence summaries using the GRADE and the CINeMA methodology, and a panel of general surgeons, gastroenterologists, and a patient representative contributed to the development of a GRADE evidence-to-decision framework to select among multiple interventions.

Results

The panel reached unanimous consensus on the first Delphi round. We suggest LCBDE over preoperative, intraoperative, or postoperative ERCP, when surgical experience and expertise are available; intraoperative ERCP over LCBDE, preoperative or postoperative ERCP, when this is logistically feasible in a given healthcare setting; and preoperative ERCP over LCBDE or postoperative ERCP, when intraoperative ERCP is not feasible and there is insufficient experience or expertise with LCBDE (weak recommendation). The evidence summaries and decision aids are available on the platform MAGICapp (https://app.magicapp.org/#/guideline/nJ5zyL).

Conclusion

We developed a rapid guideline on the management of common bile duct stones in line with latest methodological standards. It can be used by healthcare professionals and other stakeholders to inform clinical and policy decisions.

Guideline registration number

IPGRP-2022CN170.

Nur mit Berechtigung zugänglich

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Titel: EAES rapid guideline: updated systematic review, network meta-analysis, CINeMA and GRADE assessment, and evidence-informed European recommendations on the management of common bile duct stones
verfasst von: Luigi Boni
Bright Huo
Laura Alberici
Claudio Ricci
Sofia Tsokani
Dimitris Mavridis
Yasser Sami Amer
Alexandros Andreou
Thomas Berriman
Gianfranco Donatelli
Nauzer Forbes
Stylianos Kapiris
Cüneyt Kayaalp
Leena Kylänpää
Pablo Parra-Membrives
Peter D. Siersema
George F. Black
Stavros A. Antoniou
Publikationsdatum: 13.10.2022
Verlag: Springer US
Erschienen in: Surgical Endoscopy / Ausgabe 11/2022
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-022-09662-4

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EAES rapid guideline: updated systematic review, network meta-analysis, CINeMA and GRADE assessment, and evidence-informed European recommendations on the management of common bile duct stones