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Urgent endoscopic retrograde cholangiopancreatography is not superior to early ERCP in acute biliary pancreatitis with biliary obstruction without cholangitis

Authors
 Hee Seung Lee  ;  Moon Jae Chung  ;  Jeong Youp Park  ;  Seungmin Bang  ;  Seung Woo Park  ;  Si Young Song  ;  Jae Bock Chung 
Citation
 PLoS One, Vol.13(2) : e0190835, 2018 
Journal Title
 PLoS One 
Issue Date
2018
MeSH
Acute Disease ; Adult ; Aged ; 80 and over Aged ; Endoscopic Retrograde/adverse effects/*methods Cholangiopancreatography ; Cholangitis/complications ; Cholestasis/*complications/*diagnosis/surgery ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Pancreatitis/*diagnosis/*etiology/surgery ; Republic of Korea ; Retrospective Studies ; Time Factors
Abstract
Acute pancreatitis is a common diagnosis worldwide, with gallstone disease being the most prevalent cause (50%). The American College of Gastroenterology recommends urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 h) for patients with biliary pancreatitis accompanied by cholangitis. Most international guidelines recommend that ERCP be performed within 72 h in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, but the optimal timing for endoscopy is controversial. We investigated the optimal timing for ERCP in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, and whether performing endoscopy within 24 h is superior to performing it after 24 h. We analyzed the clinical data of 505 patients with newly diagnosed acute pancreatitis, from January 1, 2005 to December 31, 2014. We divided the patients into two groups according to the timing of ERCP: < 24 h (urgent) and 24-72 h (early).Among the 505 patients, 73 were diagnosed with biliary pancreatitis and a bile duct obstruction without cholangitis. The mean age of the patients was 55 years (range: 26-90 years). Bile duct stones and biliary sludge were identified on endoscopy in 45 (61.6%) and 11 (15.0%) patients, respectively. The timing of ERCP within 72 h was not associated with ERCP-related complications (P = 0.113), and the total length of hospital stay was not different between urgent and early ERCP (5.9 vs. 5.7 days, P = 0.174). No significant differences were found in total length of hospitalization or procedural-related complications, in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, according to the timing of ERCP (< 24 h vs. 24-72 h).
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DOI
10.1371/journal.pone.0190835
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
박승우(Park, Seung Woo) ORCID logo https://orcid.org/0000-0001-8230-964X
박정엽(Park, Jeong Youp) ORCID logo https://orcid.org/0000-0003-0110-8606
방승민(Bang, Seungmin) ORCID logo https://orcid.org/0000-0001-5209-8351
송시영(Song, Si Young) ORCID logo https://orcid.org/0000-0002-1417-4314
이희승(Lee, Hee Seung) ORCID logo https://orcid.org/0000-0002-2825-3160
정문재(Chung, Moon Jae) ORCID logo https://orcid.org/0000-0002-5920-8549
정재복(Chung, Jae Bock)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161959
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