{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:51:40Z","timestamp":1793386300217,"version":"4.5.0"},"reference-count":101,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2025,9]]},"abstract":"Main statements<\/jats:title>\n Quality standards\u2002Competence in cholangioscopy should be defined as the ability to successfully perform the procedure effectively, without trainer assistance, in 80\u200a% of procedures. Cholangioscopy should be performed in endoscopy units with a high yearly volume of endoscopic retrograde cholangiopancreatographies (ERCPs) of all grades of complexity.<\/jats:p>\n Cholangiopancreatoscopy practice should be considered as standard or advanced as follows:<\/jats:p>\n \u2212 \n Standard\n Cholangioscopy for extrahepatic biliary stones; evaluation of extrahepatic biliary strictures; selective ductal guidewire cannulation and removal of migrated biliary stents\/foreign body extraction<\/jats:p>\n \u2212 \n Advanced\n Cholangioscopy for intrahepatic biliary strictures or complex hepatolithiasis; percutaneous cholangioscopy and pancreatoscopy.<\/jats:p>\n Endoscopy units undertaking standard cholangioscopy should have prompt access to the following (on site or within a defined rapidly responsive network):<\/jats:p>\n \u2212 Endoscopic ultrasound (EUS)<\/jats:p>\n \u2212 Interventional radiology (on-site) and hepaticopancreaticobiliary (HPB) surgery<\/jats:p>\n \u2212 HPB multidisciplinary meetings (MDMs).<\/jats:p>\n Complete extrahepatic stone clearance at the initial cholangioscopy session should be successful in 80\u200a% of intention-to-treat cases.<\/jats:p>\n Cholangioscopy is recommended with visually guided biopsies in the evaluation of undefined biliary strictures, ideally at index ERCP to prevent negative visual and histological effects of prior stenting; except in cases with an associated mass lesion that may allow tissue acquisition by other means (e.\u200ag. EUS or percutaneous biopsy).<\/jats:p>\n In cholangioscopic evaluation of extrahepatic biliary strictures, visual assessment should be achieved in >\u200a90\u200a% of cases, and at least 4 visually guided biopsies should be undertaken with sufficient tissue for histological assessment being obtained in >\u200a80\u200a% of cases.<\/jats:p>\n Percutaneous transhepatic cholangioscopy is indicated in patients with transhepatic bile duct access in cases of altered anatomy or failed ERCP and an indication for cholangioscopy (stone management; biliary stricture evaluation; foreign body removal).<\/jats:p>\n Curriculum for training\u2002Cholangioscopy is considered an advanced adjunct to ERCP, and prior to undertaking supervised cholangioscopic procedures trainees should be competent in the basic skills of ERCP (Schutz level 1 and 2) as defined by ESGE (duodenal intubation; biliary cannulation; distal bile duct stenting;\u200a\u2264\u200a10-mm stone extraction).<\/jats:p>\n Cholangioscopy training should take place in expert referral centers with a high volume of ERCP and cholangioscopy cases.<\/jats:p>\n A trainee\u2019s principal trainer should be an experienced trainer ideally with at least 3 years of experience in undertaking independent cholangioscopy to the determined quality standards.<\/jats:p>\n Competence in cholangioscopy should be defined as the ability to successfully perform the procedure effectively without trainer assistance in 80\u200a% of procedures.<\/jats:p>","DOI":"10.1055\/a-2619-8434","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T19:14:30Z","timestamp":1751310870000},"page":"1056-1069","source":"Crossref","is-referenced-by-count":10,"title":["Quality standards and curriculum for training in cholangiopancreatoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement"],"prefix":"10.1055","volume":"57","author":[{"given":"Gavin","family":"Johnson","sequence":"additional","affiliation":[{"name":"Pancreaticobiliary Unit, University College London Hospital, London, UK"},{"name":"Cleveland Clinic, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Webster","sequence":"additional","affiliation":[{"name":"Pancreaticobiliary Unit, University College London Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3563-4973","authenticated-orcid":false,"given":"Apostolis","family":"Papaefthymiou","sequence":"additional","affiliation":[{"name":"Pancreaticobiliary Unit, University College London Hospital, London, UK"},{"name":"Cleveland Clinic, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Teles de Campos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Anderloni","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4034-7570","authenticated-orcid":false,"given":"Wafaa","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8194-2670","authenticated-orcid":false,"given":"Ivo","family":"Boskoski","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Fondazione IRCCS Policlinico Universitario Agostino Gemelli, Rome, 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Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1\u0161","family":"Hucl","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Kyl\u00e4np\u00e4\u00e4","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Manno","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Azienda USL di Modena, Carpi Hospital, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Werner","family":"Poley","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Maastricht UMC+, Maastricht, The 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