title: Preprocedural considerations in gastrointestinal endoscopy.
abstract: The current practice of open-access endoscopy allows primary care and other non-gastroenterology physicians to directly refer patients for routine gastrointestinal endoscopic procedures. Open-access endoscopy is considered to be more cost-effective and time efficient than the traditional practice of referring patients for preprocedural consultation with a gastrointestinal endoscopist. Several studies have evaluated the performance of endoscopic procedures in an open-access environment and the utility of structured referral mechanisms to ensure safe and appropriately indicated procedures. This review focuses on 4 common preprocedural issues in gastrointestinal endoscopy encountered by primary care physicians: management of anticoagulation and antiplatelet therapy, indication for prophylactic antibiotic drug therapy, need for anesthesia-assisted sedation, and management of poor bowel preparation. We summarize the current guidelines that address these 4 common preprocedural issues to facilitate safe and clinically appropriate procedures in open-access endoscopy.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Emmanuel C
authors.initials: EC
authors.lastname: Gorospe
authors.forename: Amy S
authors.initials: AS
authors.lastname: Oxentenko
mesh_terms: D019072:Antibiotic Prophylaxis / Q000379:methods; D000925:Anticoagulants / Q000009:adverse effects; D002400:Cathartics / Q000627:therapeutic use; D016292:Procedural Sedation / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D011320:Primary Health Care
chemical_list: D000925:Anticoagulants; D002400:Cathartics; D010975:Platelet Aggregation Inhibitors
keywords: ASGE; American Society for Gastrointestinal Endoscopy; CrCl; EGD; ERCP; EUS; FNA; OAE; PEG; PEJ; creatinine clearance; endoscopic retrograde cholangiopancreatography; endoscopic ultrasonography; esophagogastroduodenoscopy; fine-needle aspiration; open-access endoscopy; percutaneous endoscopic gastrostomy; percutaneous endoscopic jejunostomy