ISSN: 1859 - 2872
Urgent endoscopic retrograde cholangiopancreatography for acute chol-angitis due to common bile duct stones in elderly patients
Main Article Content
Keywords
Abstract
Objective: Evaluate the effectiveness of emergency ERCP intervention timing in elderly patients with acute cholangitis due to common bile duct stones. Subject and method: 108 patients ≥ 75 years old with acute cholangitis due to CBD stones at 108 Military Central Hospital from February 2021 to April 2024 were enrolled in this study. Result: The mean age was 83.23 ± 5.42; Presenting symptoms with abdominal pain, fever, and jaundice accounted for 70.4%, 60.2% and 69.4%, respectively. The rate of patients had comorbidity was 74.1%, 59.6% patients with severe cholangitis, in which has 57.6% underwent urgent ERCP. The proportion of biliary drainage and stone removal accounted for 43.5%and 56.5%, respectively. Cure rate is 93.5%. Mortality rate was 6.5% and related to delay ERCP > 24 hours was 71.4%. Mean hospital stay was 6.91 ± 6.74 in ERCP ≤ 24 hours group. Conclusion: The timing and method of ERCP intervention depend on the severity of cholangitis. Urgent ERCP ≤ 24 hours reduces mortality and hospital stay duration.
Article Details
References
2. Huang YC, Wu CH, Lee MH, Wang SF, Tsou YK, Lin CH et al (2022) Timing of endoscopic retrograde cholangiopancreatography in the treatment of acute cholangitis of different severity. World J Gastroenterol 28(38): 5602-5613.
3. Iqbal U, Khara HS, Hu Y, Khan MA, Ovalle A, Siddique O et al (2020) Emergent versus urgent ERCP in acute cholangitis: A systematic review and meta-analysis. Gastrointest Endosc 91(4): 753-760.
4. Miura F, Okamoto K, Takada T, Strasberg SM, Asbun HJ, Pitt HA et al (2018) Tokyo Guidelines 2018: Initial management of acute biliary infection and flowchart for acute cholangitis. J Hepatobiliary Pancreat Sci 25(1): 31-40.
5. Vũ Thị Phượng, Dương Minh Thắng, Phạm Minh Ngọc Quang (2019) Kết quả nội soi mật tụy ngược dòng cấp cứu điều trị viêm đường mật và viêm tụy cấp thể phù nề do sỏi ống mật chủ. Tạp chí Y Dược lâm sàng 108, 14(7), tr. 7-12.
6. Park CS, Jeong HS, Kim KB, Han JH, Chae HB, Youn SJ, Park SM (2016) Urgent ERCP for acute cholangitis reduces mortality and hospital stay in elderly and very elderly patients. Hepatobiliary Pancreat Dis Int 15(6): 619-625.
7. Gomi H, Solomkin JS, Schlossberg D, Okamoto K, Takada T, Strasberg SM et al (2018) Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci 25(1): 3-16.
8. Tabibian JH, Kane SV (2015) Letter: Acute cholangitis understanding predictors of outcome. Aliment Pharmacol Ther 42(6): 777.
9. Park N, Lee SH, You MS, Kim JS, Huh G, Chun JW et al (2021) Optimal timing of endoscopic retrograde cholangiopancreatography for acute cholangitis associated with distal malignant biliary obstruction. BMC Gastroenterol 21(1): 175.
10. Mukai S, Itoi T, Tsuchiya T, Ishii K, Tanaka R, Tonozuka R, Sofuni A (2023) Urgent and emergency endoscopic retrograde cholangiopancreatography for gallstone-induced acute cholangitis and pancreatitis. Dig Endosc 35(1): 47-57.
11. Shah SL, Carr-Locke D (2020) ERCP for acute cholangitis: timing is everything. Gastrointest Endosc 91(4): 761-762.