Comparison of the results of early and elective endoscopic retrograde cholangiopancreatography in patients with mild cholangitis

Year 2024, , 112 - 117, 30.04.2024

Rasim Eren Cankurtaran , Osman Ersoy

https://doi.org/10.47582/jompac.1433605

Abstract

Aims: The optimal duration of endoscopic retrograde cholangiopancreatography (ERCP) in patients with mild cholangitis and when it should be performed is unclear. This study aimed to compare the results of patients with mild cholangitis who underwent early and elective ERCP.
Methods: This study was designed as a retrospective study to compare the results of elective (time from admission to ERCP>72 h) and early (time from admission to ERCP≤72 h) ERCP in patients with mild cholangitis according to the Tocyo 18 (TC18) guideline. The study included patients with naive papillae and mild cholangitis who underwent ERCP between February 2019 and 2023 at a single tertiary center’s gastroenterology clinic.
Results: A total of 432 mild cholangitis patients were included in our study. The mean age and ASA score of the elective ERCP group was slightly higher than the other group (respectively, p=0.039 and p=0.025). No significant difference was found between the two groups in terms of technical and clinical success, mortality, ERCP-related adverse events, organ failure and intensive care unit admission. Length of hospital stay (LHS) was significantly (p<0.001) higher in the elective group compared to the early group.
Conclusion: Our study showed that in patients with mild cholangitis with uncertain optimal ERCP time, ERCP in the early or elective period had no significant effect on mortality and other adverse outcomes, but ERCP in the early period shortened the patients’ LHS duration.

Keywords

ERCP, mild cholangitis, mortality, pancreatitis

Ethical Statement

Ethical approval was obtained from the local ethics committee (date: 26.05.2021, approval number:26379996/74) and the study was conducted in accordance with the tenets of the Declaration of Helsinki.

Supporting Institution

This research received no external funding.

Hafif kolanjitli hastalarda erken ve elektif endoskopik retrograd kolanjiyopankreatografi sonuçlarının karşılaştırılması

Abstract

Amaçlar:
Hafif kolanjitli hastalarda endoskopik retrograd kolanjiyopankretografinin (ERCP) optimal süresi ve ne zaman yapılması gerektiği belirsizdir. Bu çalışmanın amacı, erken ve elektif ERCP yapılan hafif kolanjitli hastaların sonuçlarını karşılaştırmaktır.
Yöntemler:
Bu çalışma, Tocyo 18 (TC18) kılavuzuna göre hafif kolanjitli hastalarda elektif (başvurudan ERCP'ye kadar geçen süre>72 saat) ve erken (başvurudan ERCP'ye kadar geçen süre≤72 saat) ERCP sonuçlarını karşılaştırmak için retrospektif bir çalışma olarak tasarlanmıştır. Çalışmaya, Şubat 2019 ile 2023 tarihleri arasında tek bir üçüncü basamak merkezin gastroenteroloji kliniğinde ERCP yapılan naif papilla ve hafif kolanjit hastaları dahil edilmiştir.
Sonuçlar:
Çalışmamıza toplam 432 hafif kolanjit hastası dahil edildi. Elektif ERCP grubunun ortalama yaşı ve ASA skoru diğer gruptan biraz daha yüksekti (sırasıyla, p=0.039 ve p=0.025). İki grup arasında teknik ve klinik başarı, mortalite, ERCP ile ilişkili advers olaylar, organ yetmezliği ve yoğun bakım ünitesine yatış açısından anlamlı bir fark bulunmadı. Hastanede kalış süresi (LHS) elektif grupta erken gruba kıyasla anlamlı olarak (p<0.001) daha yüksekti.
Sonuç:
Çalışmamız, optimal ERCP zamanı belirsiz olan hafif kolanjitli hastalarda, erken veya elektif dönemde ERCP'nin mortalite ve diğer olumsuz sonuçlar üzerinde anlamlı bir etkisi olmadığını, ancak erken dönemde ERCP'nin hastaların LHS süresini kısalttığını göstermiştir.

Keywords

ERCP, Hafif kolanjit, mortalite, pankreatit

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