Abstract
Background
Acute cholangitis (AC) is an infection of the biliary tract secondary to biliary obstruction
requiring biliary drainage through endoscopic retrograde cholangiopancreatography.
This study aims to compare the outcome between the early and delayed ERCP in patients
with severe AC.
Methods
Patient with severe AC due to choledocholithiasis admitted to intensive care unit
were included. Early ERCP was defined was as ERCP performed within 24 h following
hospital admission. Propensity-score matching was used to reduce the imbalance between
groups. The primary outcome was 30-day mortality. Secondary outcomes included length
of hospital and ICU stay, onset or persistent organ failure.
Results
The delayed ERCP group had a higher mortality rate at 30 days (45,5 versus 13%, <0.001)
and at 1 year (59,7% versus 15,6%, p <0.001). Delayed ERCP had also a higher rate of respiratory adverse events (54,5
versus 27,8%, p = 0,002), longer ICU (7.41 versus 4.61, p = 0,004) and hospital (11,88 versus 9,22, p = 0,042) length of stay. Predictors of delayed ERCP were cardiac arrythmias, liver
disease, creatinine value and white blood cell count at baseline.
Conclusions
Delays in ERCP for patients with severe AC appear to be associated with higher mortality
rate and prolonged ICU and hospital stays.
Keywords
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Article info
Publication history
Published online: February 24, 2023
Accepted:
January 20,
2023
Received:
September 27,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
