J Korean Soc Emerg Med.  2021 Oct;32(5):400-407.

What is the appropriate time for emergent endoscopic retrograde cholangiopancreatography in patients with acute cholangitis?

• Lee J
• Kim G
• Jang TC
• Seo YW
• Ko SH
• Lee SH

Abstract

Objective
Acute cholangitis is a clinical condition caused by infection of an obstructed biliary system, which is normally managed with intravenous fluids, antibiotics, and biliary drainage. Although endoscopic retrograde cholangiopancreatography (ERCP) is the preferred method of biliary drainage, guidelines for biliary drainage time remain unclear.
Methods
The current research is a retrospective study of patients with acute cholangitis who had undergone ERCP between January 2016 and December 2019. We investigated the effect of the time taken from visit to the emergency department and commencement of the ERCP, on hospital length of stay.
Results
A total of 441 patients were included in this study. No association was observed between the severity of acute cholangitis and ERCP time. However, the length of hospital stay was significantly shorter for patients who underwent ERCP less than 12 hours after arrival at the emergency department.
Conclusion
Conducting ERCP within 12 hours of arrival is associated with reduced hospital stays, regardless of the severity of acute cholangitis.

Keyword

Cholangiopancreatography; Endoscopic retrograde; Cholangitis; Length of stay