Effect of Delayed Endoscopic Retrograde Cholangiopancreatography after Diagnosis of Acute Cholangitis; A Real-life Experience

Tanyaporn Chantarojanasiri; Pattrawin Kittipichai; Apichet Sirinawasatein; Kannikar Laohavichitra; Thawee Ratanachu-Ek

doi:10.33192/smj.v76i4.267489

Authors

Tanyaporn Chantarojanasiri Division of Gastroenterology, Department of Internal Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Pathum Thani, Thailand
Pattrawin Kittipichai Division of Gastroenterology, Department of Internal Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Pathum Thani, Thailand
Apichet Sirinawasatein Division of Gastroenterology, Department of Internal Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Pathum Thani, Thailand
Kannikar Laohavichitra Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
Thawee Ratanachu-Ek Department of Surgery, Rajavithi Hospital, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v76i4.267489

Keywords:

cholangitis, ERCP

Abstract

Objective: Acute cholangitis is a potentially life-threatening condition. Its main treatments include antibiotics and biliary drainage, but longer waiting times for endoscopic biliary drainage may be unavoidable in some limited-resource settings.

Materials and Methods: All patients who presented with cholangitis and received ERCP during the 3-year study period were included. The associations between waiting time from the diagnosis of acute cholangitis to the endoscopic drainage and the clinical outcomes, including 30-day all-course mortality and 30-day rehospitalization rates, were compared in patients who received ERCP within 24 hours, 48 hours, 72 hours, 7 days, and later than 7 days.

Results: Overall, 300 patients were included. The 30-day all-course mortality rate was 5%, with 9% overall rehospitalization rate, and median waiting time for ERCP of 5 days (1 -50 days). There was no significant difference between 30-day mortality rates in patients who received ERCP within 24 hours, 48 hours, 72 hours and over 7 days (p > 0.05). The mortality rate was significantly higher in those with severe cholangitis and with pancreatobiliary malignancy (p < 0.05).

Conclusion: In real life situation when resources are limited, delayed ERCP did not increased the 30-day mortality rate in patients with cholangitis.

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