Published online Apr 21, 2024. doi: 10.3748/wjg.v30.i15.2118
Peer-review started: January 18, 2024
First decision: February 9, 2024
Revised: February 19, 2024
Accepted: March 27, 2024
Article in press: March 27, 2024
Published online: April 21, 2024
Processing time: 91 Days and 23.8 Hours
During emergency endoscopic retrograde cholangiopancreatography (ERCP), the safety and feasibility of performing one-stage endoscopic treatment for patients with acute cholangitis (AC) due to choledocholithiasis are unclear.
To investigate the safety and feasibility of one-stage endoscopic treatment for moderate to severe AC.
We enrolled all patients diagnosed with moderate to severe cholangitis due to common bile duct stones from January 2019 to July 2023. The outcomes were compared in this study between patients who underwent ERCP within 24 h and those who underwent ERCP 24 h later, employing a propensity score (PS) frame
In total, we included 254 patients and categorized them into two groups based on the time elapsed between admission and intervention: The urgent group (≤ 24 h, n = 102) and the elective group (> 24 h, n = 152). Ninety-three pairs of patients with similar characteristics were selected by PS matching. The urgent ERCP group had more ICU admissions (34.4% vs 21.5%, P = 0.05), shorter ICU stays (3 d vs 9 d, P < 0.001), fewer antibiotic use (6 d vs 9 d, P < 0.001), and shorter hospital stays (9 d vs 18.5 d, P < 0.001). There were no significant differences observed in adverse events, in-hospital mortality, recurrent cholangitis occurrence, 30-d readmission rate or 30-d mortality.
Urgent one-stage ERCP provides the advantages of a shorter ICU stay, a shorter duration of antibiotic use, and a shorter hospital stay.
Core Tip: We investigated the safety and feasibility of one-stage endoscopic treatment for moderate to severe acute cholangitis. Our study found that patients who underwent endoscopic retrograde cholangiopancreatography within 24 h had a shorter intensive care unit stay, a shorter duration of antibiotic use, and a shorter hospital stay.