1: ESGE recommends a prolonged course of a prophylactic broad-spectrum antibiotic in patients with ascites who are undergoing therapeutic endoscopic ultrasound (EUS) procedures.Strong recommendation, low quality evidence. 2: ESGE recommends placement of partially or fully covered self-expandable metal stents during EUS-guided hepaticogastrostomy for biliary drainage in malignant disease.Strong recommendation, moderate quality evidence. 3: ESGE recommends EUS-guided pancreatic duct (PD) drainage should only be performed in high volume expert centers, owing to the complexity of this technique and the high risk of adverse events.Strong recommendation, low quality evidence. 4: ESGE recommends a stepwise approach to EUS-guided PD drainage in patients with favorable anatomy, starting with rendezvous-assisted endoscopic retrograde pancreatography (RV-ERP), followed by antegrade or transmural drainage only when RV-ERP fails or is not feasible.Strong recommendation, low quality evidence. 5: ESGE suggests performing transduodenal EUS-guided gallbladder drainage with a lumen-apposing metal stent (LAMS), rather than using the transgastric route, as this may reduce the risk of stent dysfunction.Weak recommendation, low quality evidence. 6: ESGE recommends using saline instillation for small-bowel distension during EUS-guided gastroenterostomy.Strong recommendation, low quality evidence. 7: ESGE recommends the use of saline instillation with a 19G needle and an electrocautery-enhanced LAMS for EUS-directed transgastric endoscopic retrograde cholangiopancreatography (EDGE) procedures.Strong recommendation, low quality evidence. 8: ESGE recommends the use of either 15- or 20-mm LAMSs for EDGE, with a preference for 20-mm LAMSs when considering a same-session ERCP.Strong recommendation, low quality evidence.

Department of Gastroenterology Aix Marseille Université APHM Hôpital Nord Marseille France

Department of Gastroenterology and Hepatology Amsterdam UMC Vrije Universiteit Amsterdam AGEM Institute Amsterdam The Netherlands

Department of Gastroenterology and Hepatology Imelda General Hospital Bonheiden Belgium

Department of Gastroenterology and Hepatology Institute for Clinical and Experimental Medicine Prague Czech Republic

Department of Gastroenterology and Hepatology Leeds Teaching Hospital NHS Trust Leeds UK

Department of Gastroenterology and Hepatology Leiden University Medical Center Leiden The Netherlands

Department of Gastroenterology and Hepatology Mayo Clinic Rochester Minnesota USA

Department of Gastroenterology and Hepatology Université catholique de Louvain CHU UCL Namur Yvoir Belgium

Department of Gastroenterology and Hepatology University Hospitals Leuven Leuven Belgium

Department of Medical Gastroenterology Asian Institute of Gastroenterology Hospitals Gachibowli Hyderabad India

Department of Surgery Department of Gastroenterology and Hepatology and Department of Advanced Interventional Endoscopy Universitair Ziekenhuis Brussel Vrije Universiteit Brussel Brussels Belgium

Digestive Endoscopy Unit Fondazione Policlinico Universitario A Gemelli IRCCS Università Cattolica del Sacro Cuore and Center for Endoscopic Research Therapeutics and Training Catholic University Rome Italy

Division of Gastroenterology and Hepatology Johns Hopkins Hospital Baltimore Maryland USA

Gastroenterology Department Colentina Clinical Hospital Bucharest Romania

Gastroenterology Department Hospital Universitario Rio Hortega Valladolid Spain

Interventional Endoscopy Services California Pacific Medical Center San Francisco California USA

Pancreatobiliary Endoscopy and Endosonography Division IRCCS San Raffaele Scientific Institute Milan Italy

Paoli Calmettes Institute Department of Gastrointestinal Disease Marseille France

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