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The Effectiveness of Emergency Endoscopic Retrograde Cholangiopancreatography in Patients with Severe Acute Cholangitis

By M. B. (Muhammad) Bestari, N. (Nenny) Agustanti, Y. (Yelica) Rachmat, D. (Dolvy) Girawan, A. (Ali) Djumhana, J. R. (Juke) Saketi and S. A. (Siti) Abdurachman

Abstract

Background: The aim of this study was to assess the frequency, indications, yield and outcome of emergent endoscopy retrograde cholangiopancreatography (ERCP) in severe acute cholangitis patients. Method: Records of all cholangitis patients undergoing ERCP were reviewed over a six months period. Indications, findings, therapeutic interventions and survival were analyzed. Indications for urgent drainage were temperature greater than 38ºC, increasing abdominal pain, jaundice and any organ involvement. Results: Of 80 ERCPs, 19 (23.75%) were severe acute cholangitis patients underwent emergency ERCP. The common bile duct was the duct of interest in all patients and was cannulated in 100%. The most common findings were choledocholithiasis (42.1%) and pancreatic head cancer (42.1%), followed by cholangiocarcinoma (10.5%) and papil vater carcinoma (5.3%). There were 12 (63.2%) septic shock patients with systolic blood pressure less than 90 mmHg and heart rate greater than 90 beats/minute who required inotropic drugs. Endoscopic biliary drainage was performed using 8.5 F biliary stent (73.7%) or common bile duct (CDB) stones removal (26.3%). The overall 30 days mortality was 0. Conclusion: Emergency ERCP in severe acute cholangitis is associated with improvement of clinical and some laboratory parameters without a complication of acute pancreatitis. In cases of chIoledocholithiasis, it can be performed with stone extraction as well as stent insertio

Topics: Indonesia, endoscopic stenting in difficult hilar biliary stricture, emergent ERCP, severe acute cholangitis
Publisher: Indonesian Society of Gastroenterology
Year: 2010
OAI identifier: oai:neliti.com:135423
Provided by: Neliti

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