THE BURDEN OF CHOLANGITIS IN PATIENTS WITH CHOLEDOCHOLITHIASIS IN TERMS OF POST-ERCP PANCREATITIS AND PROCEDURE TIME

Aims Post-ERCP pancreatitis (PEP) is a worrisome and common adverse event of ERCP and is thought to have a multifactorial mechanism. We analyzed if acute cholangitis is a risk factor for PEP and if the procedure time and time to ERCP (TtE) differ in patients with or without acute cholangitis.

Methods We performed a retrospective study that included patients with choledocholithiasis. The indication for ERCP was given by the presence of biliary obstruction or acute cholangitis (classified according to Tokyo 2018 criteria). The development of PEP, time to ERCP (TtE) and procedure duration were assessed between patients with acute cholangitis in comparison with those without.

Results We analyzed 602 consecutive patients (mean age 65.7±15.2 years, 45.7% males). In 61.1% (368/602) the obstruction was caused by choledocholithiasis out of which 38.6% patients (142/368) had acute cholangitis (AC). From the AC subgroup, 14.1% (20/142) patients developed PEP, while 9.3% (21/226) of those without developed PEP (p=0.2099). Mean procedure time (minutes) was 33.1±12.9 in AC group vs. 31.09±14.8 in non-AC (p=0.1861), while TtE was lower in the AC group 45.5±39.8 hours vs. 55.3±42.4 hours (p=0.0278).

Conclusions PEP was not influenced by acute cholangitis in our cohort of patients with choledocholitiasis

Publication History

Article published online:
14 April 2022