Digestive Diseases and Sciences

, Volume 58, Issue 7, pp 2082–2087

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

Authors

  • Sang Eon Jang
    • Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang Hospital
  • Sang Wook Park
    • Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang Hospital
  • Ban Seok Lee
    • Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang Hospital
  • Cheol Min Shin
    • Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang Hospital
  • Sang Hyub Lee
    • Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang Hospital
  • Jin-Wook Kim
    • Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang Hospital
  • Sook-Hyang Jeong
    • Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang Hospital
  • Nayoung Kim
    • Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang Hospital
  • Dong Ho Lee
    • Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang Hospital
  • Joo Kyung Park
    • Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang Hospital
    • Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang Hospital
Original Article

DOI: 10.1007/s10620-013-2595-z

Cite this article as:
Jang, S.E., Park, S.W., Lee, B.S. et al. Dig Dis Sci (2013) 58: 2082. doi:10.1007/s10620-013-2595-z

Abstract

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 < 0.001), and furthermore, intervention to discharge time was also significantly shorter by 1.1 days in the urgent group (P = 0.035). In terms of laboratory parameters, initial CRP level was the only factor correlated with hospital stay and intervention to discharge time.

Conclusions

This study demonstrates that urgent ERCP would be recommended in the management of patients with CBD stone-related mild to moderate acute cholangitis because of the advantage of short hospital stay and intervention to discharge time.

Keywords

CholangitisElectiveUrgent

Copyright information

© Springer Science+Business Media New York 2013