Main RecommendationsESGE recommends offering stone extraction to all patients with common bile duct stones, symptomatic or not, who are fit enough to tolerate the intervention.Strong recommendation, low quality evidence.ESGE recommends liver function tests and abdominal ultrasonography as the initial diagnostic steps for suspected common bile duct stones. Combining these tests defines the probability of having common bile duct stones.Strong recommendation, moderate quality evidence.ESGE recommends endoscopic ultrasonography or magnetic resonance cholangiopancreatography to diagnose common bile duct stones in patients with persistent clinical suspicion but insufficient evidence of stones on abdominal ultrasonography.Strong recommendation, moderate quality evidence.ESGE recommends the following timing for biliary drainage, preferably endoscopic, in patients with acute cholangitis, classified according to the 2018 revision of the Tokyo Guidelines:– severe, as soon as possible and within 12 hours for patients with septic shock– moderate, within 48 – 72 hours– mild, elective.Strong recommendation, low quality evidence.ESGE recommends endoscopic placement of a temporary biliary plastic stent in patients with irretrievable biliary stones that warrant biliary drainage.Strong recommendation, moderate quality of evidence.ESGE recommends limited sphincterotomy combined with endoscopic papillary large-balloon dilation as the first-line approach to remove difficult common bile duct stones. Strong recommendation, high quality evidence.ESGE recommends the use of cholangioscopy-assisted intraluminal lithotripsy (electrohydraulic or laser) as an effective and safe treatment of difficult bile duct stones.Strong recommendation, moderate quality evidence.ESGE recommends performing a laparoscopic cholecystectomy within 2 weeks from ERCP for patients treated for choledocholithiasis to reduce the conversion rate and the risk of recurrent biliary events. Strong recommendation, moderate quality evidence.

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Endoscopic papillectomy of selected ampullary tumors is curative in 81.0 % of cases. It must be considered to be the first-line treatment for early tumors of the ampulla of Vater without intraductal invasion.

In this single-center series, we found a complication rate of ES in about 7 %, comparable to that in multicenter series. Precut papillotomy and sphincter of Oddi dysfunction were the main independent risk factors for ES.

Rectovaginal septum endometriosis (RVSE) is a deep form of en− dometriosis in which the subperitoneal space is infiltrated by en− dometrial tissue to depths of up to 5 mm [1 ± 3]. The condition nearly always occurs in women of childbearing age, and the mean prevalence is 10 % (range 5 ±17 %) [4]. Some authors have suggested that endometriosis may occur more frequently at this particular site than the data available suggest [1, 3, 5, 6], but no consensus has been reached so far on this point.The standard treatment applied nowadays is surgery with com− plete excision of all the endometriosis encountered [1, 6 ± 16]. The rectovaginal lesions that are mainly responsible for the symptoms of this disease require specific forms of treatment. Gy− necologists should be informed before surgery about the extent to which the rectal septum is infiltrated by nodules. Surgery can be mandatory, but should not be the same if there is infiltration of the rectal wall.Background and Study Aims: Rectovaginal septal endometrios− is (RVSE) can pose serious therapeutic problems when there is infiltration of the rectal septum (which occurs in approximately half of the cases). The aim of this study was to assess the value of endoscopic ultrasonography in diagnosing rectal wall involve− ment by pelvic endometriosis. Patients and Methods: A prospective study was carried out from May 1998 to March 2003 at a single hospital center. The 30 pa− tients included in the study presented with suspected RVSE and underwent systematic anorectal endoscopic ultrasonographic exploration prior to the surgical intervention. The endoscopic ul− trasonography was carried out under general anesthesia with a 7.5−MHz miniprobe equipped with a distal balloon. Results: The anorectal endoscopic ultrasonographic examina− tion (EUS) showed the presence of endometriosis in the rectovag− inal septum in 26 patients (88 %), in the uterosacral ligaments in 10 patients (33 %), and in the ovaries in two patients (6 %). At EUS, the nodules were infiltrating the rectal wall in 17 patients (56 %). The surgical exploration demonstrated endometriosis in the rec−