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Very urgent endoscopic retrograde cholangiopancreatography is associated with early

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Title: Very urgent endoscopic retrograde cholangiopancreatography is associated with early
Authors: Sugiura, Ryo Browse this author
Naruse, Hirohito Browse this author
Yamamoto, Yoshiya Browse this author
Hatanaka, Kazuteru Browse this author
Kinoshita, Kenji Browse this author
Abiko, Satoshi Browse this author
Miyamoto, Shuichi Browse this author
Suzuki, Kazuharu Browse this author
Higashino, Masayuki Browse this author
Kohya, Risako Browse this author
Sakamoto, Naoya Browse this author →KAKEN DB
Keywords: Acute cholangitis
Endoscopic retrograde cholangiopancreatography
Length of stay
Non-severe cholangitis
  Urgent procedure
Issue Date: Mar-2022
Publisher: Aran Ediciones
Journal Title: Revista Espanola de Enfermedades Digestivas: REED
Volume: 114
Issue: 3
Start Page: 133
End Page: 139
Publisher DOI: 10.17235/reed.2021.7995/2021
Abstract: Background: endoscopic retrograde cholangiopancreatography (ERCP) is a first-line procedure for biliary drainage in patients with acute cholangitis, and there are no studies focused on very urgent ERCP within several hours of hospital arrival. This study aimed to elucidate the use of very urgent ERCP for non-severe acute cholangitis. Methods: this retrospective observational study included patients with non-severe acute cholangitis who underwent ERCP between April 2011 and June 2020 in our institution. Patients were stratified into three groups based on time to ERCP after hospital arrival: very urgent (<_ 3 hours), urgent (3-24 hours) and elective (> 24 hours). The primary outcome was length of hospital stay (LOS). Results: the study cohort included 291 patients, 168 males (57.7 %), with a median age of 76 (interquartile range, 70-83) years. In all, 47, 196 and 48 patients underwent very urgent, urgent and elective ERCP, respectively. Median LOS in the very urgent, urgent, and elective groups was 12, 14, and 15 days, respectively (Kaplan-Meier method). A shorter LOS was associated with earlier ERCP (log-rank trend test, p = 0.04). The rates of readmission within 30 days of discharge and of adverse events were not significantly different among the three groups. By multivariate analysis, very urgent ERCP was associated with a significantly earlier discharge than urgent and elective ERCP (HR, 0.71, p = 0.04 and HR, 0.47, p < 0.01, respectively). In addition, age >= 75 years, pancreatitis, albumin <_ 2.8 g/dL and two or more ERCP procedures were associated with a significantly longer LOS (HRs < 1, p < 0.05). Conclusions: very urgent ERCP for non-severe acute cholangitis was associated with early discharge.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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