Early is Not Superior to Late Endoscopic Intervention for Acute Cholangitis

Link to article at PubMed

Surg Innov. 2023 Mar 10:15533506231162995. doi: 10.1177/15533506231162995. Online ahead of print.


BACKGROUND: Acute cholangitis (AC) is a common emergency with a significant mortality risk. This study aimed to compare urgent, early, and late endoscopic retrograde cholangiopancreatography (ERCP) for AC.

METHOD: We retrospectively evaluated patients diagnosed with AC from June 2016 to May 2021. According to the time of ERCP, patients were divided into urgent (≤24 h), early (24-48 h), and late (≥48 h) groups. Primary outcomes were technical success, in-hospital mortality, and 30-day mortality. Secondary outcomes were the length of hospital stay (LOS), ERCP-related adverse events, and 30-day readmission.

RESULTS: We divided 121 patients who underwent ERCP into urgent (N = 15), early (N = 19), and late groups (N = 87). There was no in-hospital mortality and no significant difference in technical success (93.3% (urgent) vs 89.5% (early) vs 96.6% (late); P = .41) and 30-day mortality (P = .82). LOS in the urgent and early groups was shorter than that in the late group (13.93 days vs 8.82 days vs 14.20 days, respectively; P = .02). There was no difference between groups for ERCP-related adverse events and 30-day readmission rates.

CONCLUSIONS: Urgent or early ERCP was not superior to late ERCP for technical success and 30-day mortality. However, urgent or early ERCP was associated with shorter LOS than late ERCP.

PMID:36898980 | DOI:10.1177/15533506231162995

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