Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2022; 28(38): 5602-5613
Published online Oct 14, 2022. doi: 10.3748/wjg.v28.i38.5602
Timing of endoscopic retrograde cholangiopancreatography in the treatment of acute cholangitis of different severity
Yao-Chi Huang, Chi-Huan Wu, Mu Hsien Lee, Sheng Fu Wang, Yung-Kuan Tsou, Cheng-Hui Lin, Kai-Feng Sung, Nai-Jen Liu
Yao-Chi Huang, Yung-Kuan Tsou, Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Chi-Huan Wu, Mu Hsien Lee, Sheng Fu Wang, Yung-Kuan Tsou, Cheng-Hui Lin, Kai-Feng Sung, Nai-Jen Liu, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
Author contributions: Huang YC contributed to the conceptualization of the study and original manuscript; Wu CH, Lee MH and Wang SF contributed to data planning, interpretation and formal analysis; Lin CH and Sung KF contributed to data collection; Tsou YK is committed to the conceptualization of the study, manuscript writing, review and editing; Liu NJ contributed to revising the final version of the manuscript for submission.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Chang Gung Memorial Hospital (IRB No. 202200881B0).
Informed consent statement: Since this was a retrospective study using clinical routine treatment or diagnostic medical records, the Chang Gung Medical Foundation Institutional Review Board approved the waiver of the participant's consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code and dataset available from the corresponding author at flying@adm.cgmh.org.tw.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yung-Kuan Tsou, MD, Associate Professor, Doctor, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, No. 5 Fu-Shin Street, Kweishan, Taoyuan 333, Taiwan. flying@adm.cgmh.org.tw
Received: June 27, 2022
Peer-review started: June 27, 2022
First decision: August 1, 2022
Revised: August 12, 2022
Accepted: September 23, 2022
Article in press: September 23, 2022
Published online: October 14, 2022
Core Tip

Core Tip: Compared with endoscopic retrograde cholangiopancreatography (ERCP) > 24 h, ERCP ≤ 24 h group had a significantly higher intensive care unit (ICU) admission rate and shorter length of hospital stay (LOHS). Subgroup analysis showed higher ICU admission rate was only in grade III acute cholangitis (AC); shorter LOHS was only in grade II and I AC. Compared with ERCP > 48 h, ERCP ≤ 48 h group had significantly lower 30-d mortality and shorter LOHS. Subgroup analysis revealed lower 30-d mortality was only in grade III AC; shorter LOHS was only in grade II and I AC. We concluded that ERCP ≤ 48 h conferred a survival benefit in grade III AC; early ERCP shortened LOHS in grade II and I AC.