Early Endoscopic Retrograde Cholangiopancreatography Versus Conservative Treatment in Patients With Acute Biliary Pancreatitis

Coutinho, Lara; Bernardo, Wanderley Marques; Rocha, Robson S.; Marinho, Fernando A. M.; Delgado, Áureo; Moura, Eduardo Turiani Hourneaux de; Matuguma, Sérgio; Chaves, Dalton Marques; Franzini, Tomazo; Sakai, Paulo; Moura, Eduardo Guimarães Hourneaux de

doi:10.1097/mpa.0000000000001032

Cited by 18 publications

(25 citation statements)

References 23 publications

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“…Своевременная папиллотомия с экстракцией камня при ФКБДС может предотвращать развитие этих осложнений или способствовать их лечению. Кроме того, у больных с ОБП, ургентная ЭРХПГ должна использоваться при невозможности исключения ОХ, так как сочетание этих состояний существенно отягощает течение заболевания [6].…”

Section: таблица 4 результаты апробации шкалы определения показаний (unclassified

“…В отношении ОБП исследования, посвященные неотложной ЭРХПГ, показывают, как улуч-шение результатов лечения, так и отсутствие такового [6][7][8].…”

Section: Introductionunclassified

“…В целом, не влияя на летальность, раннее использование ЭРХПГ способствует уменьшению частоты местных и системных осложнений и сокращает время пребывания в стационаре [6]. Отрицательного влияния ранней ЭРХПГ на течение ОБП эти исследования не выявили [6][7][8]. Кроме того, целесообразность использования ЭРХПГ может быть обоснована невозможностью исключения ОХ у больных ОБП [6].…”

Section: Introductionunclassified

“…Отрицательного влияния ранней ЭРХПГ на течение ОБП эти исследования не выявили [6][7][8]. Кроме того, целесообразность использования ЭРХПГ может быть обоснована невозможностью исключения ОХ у больных ОБП [6].…”

Section: Introductionunclassified

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Score System for Ercp Indicating in Extrahepatic Bile Duct Obstruction

Mamontov¹

2019

Khark. Surg. Sch.

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Abstracts. Aim: to objectify indications for urgent/emergency ERCP in patients with extrahepatic biliary tract obstruction (EBTO) by using the score system Matherials and Methods. The score is used by summing the points: hyperthermia ≥ 37.3 ° C (1 point); one of three hematological points — leukocytosis ≥ 9×109/l or stab neutrophils ≥ 7% or the ratio of the number of segmented and stab neutrophils <10 (1 point); two biochemical — serum bilirubin ≥ 70 μmol / l (1 point), hyperamylasemia (1 point); thickening of the gallbladder wall ≥ 4 mm or shrunken gallbladder (1 point); the main pancreatic duct dilatation (1 point); in the presence of a periampular tumor or signs of chronic pancreatitis, one point is subtracted (- 1 point). The scale was tested on 171 patients with EBTO. Results. The threshold value of the scale was ≥3 points (p <0.001). The number of points (3, ≥4) correlated with the severity of acute cholangitis and acute biliary pancreatitis (p <0.01). Conclusions. In patients with confirmed OEDB in case of ≤2 points of the score system — urgent/emergency ERCP is not indicated; in case of ≥3 points — urgent ERCP is indicated; in case of ≥4 points emergency ERCP should be performed.

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Section: таблица 4 результаты апробации шкалы определения показаний (unclassified

Section: Introductionunclassified

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Score System for Ercp Indicating in Extrahepatic Bile Duct Obstruction

Mamontov¹

2019

Khark. Surg. Sch.

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“…Historically, ERCP with sphincterotomy in biliary pancreatitis was believed to improve prognosis by removing remaining common bile duct stones. A recent meta‐analysis of seven RCTs including 757 patients found no evidence that early routine ERCP significantly affects mortality or local/systemic complications, regardless of the predicted severity of biliary pancreatitis. More recent RCTs reported relevant confounders for the efficacy of early ERCP in biliary pancreatitis.…”

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Indications for endoscopic retrograde cholangiopancreatography and cholecystectomy in biliary pancreatitis

Schulz

Schirra

Mayerle

2019

British Journal of Surgery

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The role and timing of endoscopic retrograde cholangiopancreatography in acute biliary pancreatitis without cholangitis: A nationwide analysis

Weissman

Sharma

Ehrlich

et al. 2022

J Hepato Biliary Pancreat

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Background/Purpose The role and optimal timing of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis without cholangitis (ABPwoC) remains unclear. Using a large national database, we aimed to examine hospitalization outcomes of patients with ABPwoC as a function of the performance and timing of ERCP. Methods This was a retrospective study of adult patients with ABPwoC utilizing the National Inpatient Sample from 2016–2017. Patients who underwent inpatient ERCP were stratified into performance: within 24, 24–48, 48–72, and >72 h of hospital admission. The primary outcome was all‐cause inpatient mortality as a function of the performance and timing of ERCP; secondary outcomes, including healthcare utilization, were assessed. Multivariate modeling was used to adjust for potential confounders. Statistical analyses were conducted using STATA, version 16.0. Results Of the 70 030 patients with ABPwoC, 31.37% underwent inpatient ERCP. Performance (aOR: 0.6, p < .05), but not timing (aOR: 0.98, p = .9), of inpatient ERCP was associated with significantly lower all‐cause inpatient mortality. Urgent ERCP (within 24 h) was associated with shorter hospital length of stay, lower charges and cost, and less need for pancreatic drainage procedures, while ERCP within 72 h was associated with less frequent intensive care unit admission (all p < .05). Discussion Based on this large, nationwide analysis, inpatient ERCP for ABPwoC is associated with lower all‐cause mortality. ERCP within 24 and 72 h, though not associated with lower mortality, are associated with multiple improved clinical outcomes, including lower healthcare charges and costs.

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Early Endoscopic Retrograde Cholangiopancreatography Versus Conservative Treatment in Patients With Acute Biliary Pancreatitis

Abstract: Early ERCP decreases local adverse events, shortening the time to pain relief, to a reduction in axillary temperature, hospital stays, and cost in patients with acute biliary pancreatitis.

Cited by 18 publications

References 23 publications

Score System for Ercp Indicating in Extrahepatic Bile Duct Obstruction

Score System for Ercp Indicating in Extrahepatic Bile Duct Obstruction

Indications for endoscopic retrograde cholangiopancreatography and cholecystectomy in biliary pancreatitis

The role and timing of endoscopic retrograde cholangiopancreatography in acute biliary pancreatitis without cholangitis: A nationwide analysis

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