Abstract：
This clinical practice guideline from the American Society for Gastrointestinal Endoscopy provides an evidence-based approach for strategies to manage biliary strictures in liver transplant recipients. This document was developed using the Grading of Recommendations Assessment, Development and Evaluation framework. The guideline addresses the role of ERCP versus percutaneous transhepatic biliary drainage and covered self-expandable metal stents (cSEMSs) versus multiple plastic stents for therapy of post-transplant strictures, use of MRCP for diagnosing post-transplant biliary strictures, and administration of antibiotics versus no antibiotics during ERCP. In patients with post-transplant biliary strictures, we suggest ERCP as the initial intervention and cSEMSs as the preferred stent for extrahepatic strictures. In patients with unclear diagnoses or intermediate probability of a stricture, we suggest MRCP as the diagnostic modality. We suggest that antibiotics should be administered during ERCP when biliary drainage cannot be ensured.
摘要：
美国胃肠内窥镜学会的这项临床实践指南为肝移植受者的胆道狭窄管理策略提供了一种基于证据的方法。本文档是使用建议评估等级编制的，发展和评价框架。该指南阐述了ERCP与经皮肝穿胆道引流术、覆盖自膨式金属支架(cSEMSs)与多塑料支架治疗移植后狭窄的作用。使用MRCP诊断移植后胆管狭窄，在ERCP期间使用抗生素与不使用抗生素。在移植后胆管狭窄的患者中，我们建议ERCP作为肝外狭窄的初始干预措施,cSEMS作为首选支架.在诊断不明确或狭窄概率中等的患者中，我们建议MRCP作为诊断方式.我们建议，当无法确保胆道引流时，应在ERCP期间使用抗生素。
