Urgent ERCP for acute cholangitis reduces mortality and hospital stay in elderly and very elderly patients

Park, Chan Sun; Jeong, Hee Seok; Kim, Ki Bae; Han, Joung-Ho; Chae, Hee Bok; Youn, Sei Jin; Park, Seon Mee

doi:10.1016/s1499-3872(16)60130-3

Cited by 27 publications

(19 citation statements)

References 29 publications

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“…In that study, biliary drainage was achieved by ERCP, percutaneous transhepatic biliary drainage (PTBD), and surgery in 91, 90, and 34 patients, respectively. Similarly, in a study not restricted to patients with severe disease [225], three of six patients with failed biliary drainage (50 %) died as compared with two of 321 patients with successful biliary drainage (0.6 %).…”

Section: Timing Of Ercp In Acute Cholangitismentioning

confidence: 89%

Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline

et al. 2019

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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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Section: Timing Of Ercp In Acute Cholangitismentioning

confidence: 89%

Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline

et al. 2019

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“…The authors note that an improved outcome may be seen in grade 3 acute cholangitis if biliary drainage is performed at an even earlier stage; however, additional studies are needed [77]. Another study demonstrated that hospital stays for patients treated with biliary drainage within 24 hours of hospital admission were shorter, irrespective of severity [78].…”

Section: Variant 5: Initial Therapeutic Procedures For a Patient With mentioning

confidence: 98%

ACR Appropriateness Criteria® Radiologic Management of Biliary Obstruction

Fairchild

Hohenwalter

Gipson

et al. 2019

Journal of the American College of Radiology

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“…A secondary benefit to treating patients with early biliary drainage, regardless of severity of disease, is shorter hospital stays. 36…”

Section: Diagnosismentioning

confidence: 99%

Emergent Treatment of Acute Cholangitis and Acute Cholecystitis

Navuluri

Hoyer

Osman

et al. 2020

Semin intervent Radiol

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Acute pathology of the biliary tract including cholangitis and cholecystitis can lead to biliary sepsis if early decompression is not performed. This article provides an overview of the presenting signs and symptoms and role of interventional radiology in the management of patients with acute cholangitis or acute cholecystitis. It is especially important to understand the role of IR in the context of other treatment options including medical management, endoscopy, and surgery.

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Urgent ERCP for acute cholangitis reduces mortality and hospital stay in elderly and very elderly patients

Cited by 27 publications

References 29 publications

Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline

Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline

ACR Appropriateness Criteria® Radiologic Management of Biliary Obstruction

Emergent Treatment of Acute Cholangitis and Acute Cholecystitis

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