Performance measures for endoscopic ultrasound: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative – Update 2025

The European Society of Gastrointestinal Endoscopy (ESGE) recommends that endoscopy services across Europe adopt the following six key performance measures for endoscopic ultrasound (EUS) for monitoring and evaluation in daily practice at center and endoscopist level: (1: ) informed patient consent (100 % of procedures); (2: ) adequate documentation of landmarks (≥ 90 % of procedures); (3: ) structured training and supervision for trainees, preferably using assessment tools (≥ 20 %); (4: ) standardized description of pancreatic cystic lesions (≥ 85 %); (5: ) diagnostic tissue acquisition with EUS-guided fine-needle aspiration/fine-needle biopsy for solid lesions (≥ 85 %); (6: ) adverse events (< 5 % in cystic and < 3 % in solid lesions). A recommendation to administer antibiotics for EUS-guided puncture of cystic lesions, included in the previous ESGE quality improvement document, has been omitted in the current version based on recent evidence.