Management for CBD Stone-Related Mild to Moderate Acute Cholangitis: Urgent Versus Elective ERCP

Background There is no doubt that urgent biliary decompression needs to be done in case of severe acute cholangitis. However, it remains to be determined how early biliary decompression should be performed and elective intervention would be comparable to urgent intervention, in case of mild to moder...

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Bibliographic Details
Published in:Digestive diseases and sciences 2013-07, Vol.58 (7), p.2082-2087
Main Authors: Jang, Sang Eon, Park, Sang Wook, Lee, Ban Seok, Shin, Cheol Min, Lee, Sang Hyub, Kim, Jin-Wook, Jeong, Sook-Hyang, Kim, Nayoung, Lee, Dong Ho, Park, Joo Kyung, Hwang, Jin-Hyeok
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aged
Aged, 80 and over
Biochemistry
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis - diagnostic imaging
Cholangitis - etiology
Cholangitis - surgery
Choledocholithiasis - complications
Choledocholithiasis - diagnostic imaging
Choledocholithiasis - surgery
Decompression, Surgical - methods
Elective Surgical Procedures - methods
Endoscopic retrograde cholangiopancreatography
Female
Gastroenterology
Health aspects
Hepatology
Humans
Length of Stay - statistics & numerical data
Male
Medical colleges
Medicine
Medicine & Public Health
Middle Aged
Oncology
Original Article
Retrospective Studies
Severity of Illness Index
Time Factors
Transplant Surgery
Treatment Outcome
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Summary:Background There is no doubt that urgent biliary decompression needs to be done in case of severe acute cholangitis. However, it remains to be determined how early biliary decompression should be performed and elective intervention would be comparable to urgent intervention, in case of mild to moderate choledocholithiasis associated cholangitis. Methods One hundred ninety-five patients were enrolled who were diagnosed with mild to moderate cholangitis with common bile duct (CBD) stones between January 2006 and August 2010. They were divided into two groups according to door to intervention time, and urgent (≤24 h, n  = 130) versus elective (>24 h, n  = 82). Primary outcomes of this study were technical success rate (CBD stones removal) and clinical success rate (improvement of cholangitis) between the two groups. Hospital stay and intervention-related complications were also evaluated. Results There was no statistically significant difference in technical, clinical success rate and intervention-related complications between the urgent and elective groups ( P  = 0.737, 0.285, 0.398, respectively). Patients in the urgent group had significantly shorter hospitalization than in the elective group (6.8 vs. 9.2 days, P  
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-013-2595-z