What is the appropriate time for emergent endoscopic retrograde cholangiopancreatography in patients with acute cholangitis?

¹Department of Emergency Medicine, Daegu Catholic University Medical Center, Daegu, Korea
²Department of Emergency Medicine, Daegu Catholic University School of Medicine, Daegu, Korea

Correspondence

Gyunmoo Kim ,Tel: 053-650-4091, Fax: 053-650-4931, Email: emprof@cu.ac.kr,

Received: August 12, 2020; Revised: October 18, 2020 Accepted: November 2, 2020. Published online: October 31, 2021.

ABSTRACT

Objective:
Acute cholangitis is a clinical condition caused by infection of an obstructed biliary system, which is normally managed with intravenous fluids, antibiotics, and biliary drainage. Although endoscopic retrograde cholangiopancreatography (ERCP) is the preferred method of biliary drainage, guidelines for biliary drainage time remain unclear.
Method:
The current research is a retrospective study of patients with acute cholangitis who had undergone ERCP between January 2016 and December 2019. We investigated the effect of the time taken from visit to the emergency department and commencement of the ERCP, on hospital length of stay.
Results:
A total of 441 patients were included in this study. No association was observed between the severity of acute cholangitis and ERCP time. However, the length of hospital stay was significantly shorter for patients who underwent ERCP less than 12 hours after arrival at the emergency department.
Conclusion:
Conducting ERCP within 12 hours of arrival is associated with reduced hospital stays, regardless of the severity of acute cholangitis.

Key words: Cholangiopancreatography; Endoscopic retrograde; Cholangitis; Length of stay