Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Introduction: Acute cholangitis is a critical medical emergency. The association between the timing of ERCP and clinical outcomes of acute cholangitis is still debated. The current study aims to evaluate whether ERCP within 48 h (urgent) is associated with improved long term clinical outcomes.
Methods: This study is a single-center retrospective analysis of a prospectively maintained database. All patients admitted with acute cholangitis as per Tokyo guidelines at AIG Hospitals, Hyderabad between January 2022 to December 2022 were included. We evaluated the association between urgent ERCP and length of hospital stay, need for reintervention and readmissions, and mortality.
Results: A total of consecutive 301 patients underwent ERCP for acute cholangitis; of which 217 patients (31.3 % females; mean age 54.02 ± 14.9 years) underwent urgent ERCP. The remaining 84 (32.1 % females; mean age 56.56 ± 13.9 years) underwent routine ERCP. Fifty-eight (26.7 %) and 22 (26.2 %) patients with Grade III underwent urgent and routine ERCP respectively. The median (IQR) hospital stay for urgent ERCP was 8.00 (6.00 - 11.00) days and for routine ERCP was 11.00(8.00 - 15.00; p value 0.0001), with similar hospital stay post ERCP (p 0.26). There was no significant difference in mortality upto one year between patients who underwent urgent (22.1 %;48/217) or routine ERCP (31.0 %;26/84, p 0.135). The cox proportional hazard model showed that mortality is independently associated with older age (HR 1.034;95 %CI: 1.013 - 1.054; p 0.001) and malignancy (HR 8.64;95 %CI:4.728 - 15.790; p 0.0001). There was no significant difference between two groups in terms of need for reinterventions and readmissions.
Conclusions: Urgent ERCP for acute cholangitis is associated comparable overall mortality, need for reinterventions, and readmissions with decreased total length of hospital stay. There is an unmet need to confirm these findings by randomized controlled studies.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.dld.2024.08.037 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Complex Case of Acalculous Cholecystitis, Cholangitis, and Pancreatitis Managed With Percutaneous Cholecystostomy in a Septic Patient.
Cureus
August 2025
Gastroenterology and Hepatology, Nassau University Medical Center, East Meadow, USA.
This case report presents a complex case of acute cholecystitis, cholangitis, pancreatitis, intrahepatic abscesses, and sepsis without biliary obstruction, highlighting the challenges of managing multi-organ involvement in a critically ill individual. The patient, a middle-aged male, presented with fever, jaundice, and abdominal pain, with imaging revealing biliary ductal dilation, a distended gallbladder, and a staghorn calculus. Laboratory findings showed elevated liver enzymes, bilirubin, and lipase, supporting the diagnosis of acute cholecystitis, cholangitis, and pancreatitis.
View Article and Find Full Text PDFMixed Cellular and Antibody-Mediated Rejection-A Rare yet Morbid Occurrence.
ACG Case Rep J
October 2024
Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville, Louisville, KY.
Liver transplantation remains the definitive treatment for end-stage liver disease, yet rejection of the transplanted organ poses a significant challenge to long-term graft survival. We present a case of a 47-year-old woman who underwent liver transplantation for primary sclerosing cholangitis. Following the procedure, the patient experienced a rare phenomenon of dual rejection, characterized by both acute cellular rejection and antibody-mediated rejection.
View Article and Find Full Text PDFAcute Obstructive Jaundice Secondary to Surgical Clip Migration Into the Common Bile Duct 12 Years Following Laparoscopic Liver Resection: A Case Report.
Cureus
August 2025
Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, JPN.
Surgical clip migration to the common bile duct is a rare late complication, typically originating from clips placed at the cystic duct and most commonly reported after laparoscopic cholecystectomy. We present an exceptionally rare case of obstructive jaundice caused by clip migration from the liver dissection plane, rather than from the cystic duct, occurring 12 years after laparoscopic liver resection (LLR) and cholecystectomy and associated with chronic biliary inflammation. A 73-year-old man underwent LLR of segments 4a + 5 and cholecystectomy for hepatocellular carcinoma and was discharged on postoperative day 12 without any complications.
View Article and Find Full Text PDFDrug-induced liver injury. Part II: Late complications and hepatotoxicity monitoring.
Clin Exp Hepatol
June 2025
Department of Infectious Disease, Medical University of Gdansk, Poland.
The picture of drug-induced liver injury (DILI) is polymorphic, with variable intensity of clinical symptoms and prognosis. Most cases of DILI are acute, although the incidence of chronic hepatopathy has been reported to range from 3.4% to 39.
View Article and Find Full Text PDFModified Endoscopic Biliary Stent Combined with Photodynamic Therapy: A New Strategy for the Palliative Treatment of Extrahepatic Cholangiocarcinoma.
Photobiomodul Photomed Laser Surg
September 2025
Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Photodynamic therapy (PDT) combined with biliary stenting reportedly has better efficacy and safety in the treatment of extrahepatic cholangiocarcinoma (EHC). Considering the shortcomings of traditional PDT methods, we proposed a novel modified approach, defined as initial biliary stent placement followed by PDT, for the treatment of EHC. The study aimed to evaluate the effect and safety of biliary stent placement prior to PDT versus only stent placement on the treatment of EHC.
View Article and Find Full Text PDF