Effect of Urgent ERCP on Clinical Outcomes in Acute Cholangitis With Concurrent Acute Gallstone Pancreatitis: A Propensity Score Matching Analysis.

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-06-05 DOI:10.1002/jhbp.12164

Mustafa Comoglu, Fatih Acehan, Enes Seyda Sahiner, Huseyin Camli, Zeki Mesut Yalin Kilic, Bulent Odemis, Ihsan Ates

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引用次数: 0

Abstract

Background/purpose: Current guidelines do not provide specific recommendations regarding the timing of endoscopic retrograde cholangiopancreatography (ERCP) in patients with acute cholangitis (AC) concurrent with acute gallstone pancreatitis (AGP). This study evaluated the impact of ERCP timing on clinical outcomes.

Methods: A total of 144 patients diagnosed with AC concurrent with AGP between March 2019 and February 2024 were included in the study. Patients were classified into two groups: urgent ERCP group (ERCP ≤ 24 h) and non-urgent ERCP group (ERCP 24-72 h). Clinical outcomes were compared using propensity score matching (PSM) analysis.

Results: After PSM, two well-balanced groups of 55 patients were created. The median ERCP time was 18 (13-21) hours in the urgent group and 41 (36-54) hours in the non-urgent group. There was no significant difference in composite outcomes, including in-hospital mortality, prolonged hospital stay, severe pancreatitis, or late localized/systemic complications of pancreatitis [11 (20%) vs. 16 (29.1%); p = 0.268]. Additionally, no significant difference was observed between the groups regarding prolonged hospital stay (p = 0.506), ICU admission (p = 0.680), or in-hospital mortality (p = 0.161).

Conclusions: Urgent ERCP within 24 h does not significantly improve clinical outcomes compared to ERCP performed within 24-72 h in patients with AC and AGP.

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紧急ERCP对急性胆管炎并发急性胆石性胰腺炎临床结局的影响：倾向评分匹配分析

背景/目的：对于急性胆管炎（AC）合并急性胆石性胰腺炎（AGP）患者的内镜逆行胆管造影术（ERCP）时机，目前的指南没有提供具体的建议。本研究评估ERCP时机对临床结果的影响。方法：在2019年3月至2024年2月期间，共纳入144例诊断为AC合并AGP的患者。将患者分为紧急ERCP组（ERCP≤24 h）和非紧急ERCP组（ERCP 24 ~ 72 h）。采用倾向评分匹配（PSM）分析比较临床结果。结果：经PSM后，形成两组均衡组55例。急诊组中位ERCP时间为18（13-21）小时，非急诊组中位ERCP时间为41（36-54）小时。两组的综合结局无显著差异，包括住院死亡率、延长住院时间、严重胰腺炎或晚期局部/全身胰腺炎并发症[11例（20%）vs. 16例（29.1%）；p = 0.268]。此外，在住院时间延长（p = 0.506）、ICU入院（p = 0.680）和住院死亡率（p = 0.161）方面，两组间无显著差异。结论：与AC和AGP患者在24-72小时内进行ERCP相比，24小时内紧急ERCP并没有显著改善临床结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.