Year 2022 / Volume 114 / Number 3
Original
Very urgent endoscopic retrograde cholangiopancreatography is associated with early discharge in patients with non-severe acute cholangitis

133-139

DOI: 10.17235/reed.2021.7995/2021

Ryo Sugiura, Hirohito Naruse, Yoshiya Yamamoto, Kazuteru Hatanaka, Kenji Kinoshita, Satoshi Abiko, Shuichi Miyamoto, Kazuharu Suzuki, Masayuki Higashino, Risako Kohya, Naoya Sakamoto,

Abstract
Background: endoscopic retrograde cholangiopancreatography (ERCP) is a first-line procedure for biliary drainage in patients with acute cholangitis, and there are no studies focused on very urgent ERCP within several hours of hospital arrival. This study aimed to elucidate the use of very urgent ERCP for non-severe acute cholangitis. Methods: this retrospective observational study included patients with non-severe acute cholangitis who underwent ERCP between April 2011 and June 2020 in our institution. Patients were stratified into three groups based on time to ERCP after hospital arrival: very urgent (≤ 3 hours), urgent (3-24 hours) and elective (> 24 hours). The primary outcome was length of hospital stay (LOS). Results: the study cohort included 291 patients, 168 males (57.7 %), with a median age of 76 (interquartile range, 70-83) years. In all, 47, 196 and 48 patients underwent very urgent, urgent and elective ERCP, respectively. Median LOS in the very urgent, urgent, and elective groups was 12, 14, and 15 days, respectively (Kaplan-Meier method). A shorter LOS was associated with earlier ERCP (log-rank trend test, p = 0.04). The rates of readmission within 30 days of discharge and of adverse events were not significantly different among the three groups. By multivariate analysis, very urgent ERCP was associated with a significantly earlier discharge than urgent and elective ERCP (HR, 0.71, p = 0.04 and HR, 0.47, p < 0.01, respectively). In addition, age ≥ 75 years, pancreatitis, albumin ≤ 2.8 g/dL and two or more ERCP procedures were associated with a significantly longer LOS (HRs < 1, p < 0.05). Conclusions: very urgent ERCP for non-severe acute cholangitis was associated with early discharge.
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Sugiura R, Naruse H, Yamamoto Y, Hatanaka K, Kinoshita K, Abiko S, et all. Very urgent endoscopic retrograde cholangiopancreatography is associated with early discharge in patients with non-severe acute cholangitis. 7995/2021


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Publication history

Received: 23/03/2021

Accepted: 03/05/2021

Online First: 05/05/2021

Published: 07/03/2022

Article revision time: 38 days

Article Online First time: 43 days

Article editing time: 349 days


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