Meta-Analysis
Copyright ©The Author(s) 2023.
World J Gastroenterol. May 21, 2023; 29(19): 3027-3039
Published online May 21, 2023. doi: 10.3748/wjg.v29.i19.3027
Table 1 Baseline characteristics of the studies
Ref.
Country
Study period
Study design
Definition of AC
Population
Intervention
Outcomes
Ferstl et al[23], 2022Germany2008-2019Retrospective observational studyTG18/TG13Grade I and grade II AC after ERCPAntibiotic therapy of 6 dRecurrent cholangitis within 28 d
Kihara and Yokomizo[20], 2022JapanJanuary 2009 to August 2018Retrospective observational studyTG18/TG13Postoperative cholangitis after pancreaticoduodenectomyAntibiotic therapy and pancreaticoduoedenectomyClinical characteristics and outcomes in patients with acute cholangitis
Masuda et al[6], 2022JapanJanuary 2018 to July 2020Retrospective observational studyTG18/TG13Grade I and grade II AC after successful ERCPAntibiotic therapy of 3 d30-d-mortality, recurrent cholangitis within 3 mo, length of hospitalization, in-hospital mortality
Sokal et al[14], 2022France2016-2018Retrospective observational studyTG18/TG13Patients with AC with and without malignant etiologyCancer-associated ACDuration of antibiotic therapy, 28-d-mortality, liver abscess
Masuda et al[17], 2021JapanApril 2018 to March 2020Retrospective observational studyTG18/TG13AC patients with positive blood or bile culture and early ERCPAC due to antibiotic resistant bacteriaDuration of antibiotic therapy, duration of hospitalization, in-hospital mortality, increased disease severity
Akhtar et al[18], 2020PakistanJune 2012 to June 2017Cross-sectional observational studyTG18/TG13AC patients without liver metastases or other reason for deranged liver function test. 70% of patients received ERCP3-mo-mortalityDuration of antibiotic therapy, clinical severity, bacteremia
Haal et al[21], 2020NetherlandsJanuary 2012 to January 2017Retrospective observational studyTG18/TG13AC only due to stone in the common bile duct, without prior antibiotic therapy after ERCPAntibiotic therapy of ≤ 3 d3-mo-mortality, length of hospitalization, recurrent cholangitis, other complications
Satake et al[8], 2020JapanApril 2014 to March 2019Retrospective observational studyTG18/TG13Grade I and grade II AC only due to choledocholithiasis who underwent ERCPAntibiotic therapy of ≤ 3 d30-d-mortality, length of hospitalization, recurrent cholangitis within 3 mo
Netinatsunton et al[16], 2019ThailandAugust 2017 to August 2018Randomized controlled trialTG18/TG13AC only due to choledocholithiasis without presence of the Reynold´s pentad. Time to ERCP same between the study groupsAntibiotic therapy of ≤ 14 dRecurrent cholangitis, length of hospitalization
Doi et al[22], 2018JapanJanuary 2012 to February 2017Retrospective observational studyICD-10 and positive blood cultureAC and positive blood cultureAntibiotic therapy of ≤ 7 d30-d-mortality, recurrent cholangitis within 3 mo (recurrence of symptoms)
Tagashira et al[13], 2017JapanJanuary 2009 to December 2015Retrospective observational studyTG18/TG13Bacteriemic AC and ERCP where indicatedAdequate initial antibiotic therapyDuration of antibiotic treatment, 30-d mortality
Uno et al[12], 2017JapanJuly 2012 to March 2014Retrospective observational studyTG18/TG13AC patients with gram-negative bacteriemia and after ERCPAntibiotic therapy of ≤ 14 d30-d mortality, recurrent cholangitis within 3 mo, antimicrobial treatment duration
Park et al[15], 2014South KoreaSeptember 2010 to November 2012Randomized controlled trialTG07AC with bacteremia and ERCP within 24 h after admissionIntravenous antibiotic therapy of 6 d plus 8 d oral antibiotic therapy30-d mortality, length of hospitalization, eradication of bacteria after 30 d
Kogure et al[19], 2011JapanSeptember 2007 to August 2009Retrospective observational studyTG07Moderate and severe AC with ERCPAntibiotic therapy of 3 dRecurrent cholangitis
Van Lent et al[11], 2002NetherlandsFebruary 1999 to September 1999Retrospective observational studyFever > 38 °C and elevated bilirubin levels or bile duct dilatation in ultrasoundAC after successful ERCP. Exclusion of patients with primary sclerosing cholangitis, liver transplant recipients, bile duct atresia, inflammatory bowel diseaseAntibiotic therapy of ≤ 3 d6-mo mortality and recurrent cholangitis
Table 2 Quality assessment of the observational studies

Ferstl et al[23], n = 115
Kihara and Yokomizo[20], n = 112
Masuda et al[6], n = 11
Sokal et al[14], n = 107
Masuda et al[17], n = 110
Akhtar et al[18], n = 55
Haal et al[21], n = 113
Satake et al[8], n = 101
Doi et al[22], n = 114
Tagashira et al[13], n = 106
Uno et al[12], n = 105
Kogure et al[19], n = 111
Van Lent et al[11], n = 104
Selection
Representativeness of exposed cohort*-*-*********
Selection of non-exposed cohort*************
Ascertainment of exposure*************
Demonstration that outcome of interest was not present at start of study*************
Comparability
Comparability of the cohorts**-**-**-****--**--
Outcome
Assessment of outcome*************
Was follow-up long enough for outcomes to occur?*************
Adequacy of follow-up cohorts*************
OverallGoodLowGoodLowGoodLowGoodGoodLowLowGoodLowLow