Procalcitonin to Predict Severity of Acute Cholangitis and Need for Urgent Biliary Decompression: Systematic Scoping Review

Abstract

Background: Serum Procalcitonin (PCT) has been reported as a potential biomarker to predict the severity of acute cholangitis (AC) or the need for urgent biliary decompression. This study aimed to identify and summarize the existing research about the serum PCT and the severity of AC, and to find gaps where future studies can be targeted towards. Methods: Following the PRISMA Extension for Scoping Reviews, MEDLINE, EMBASE, and Google Scholar were searched for all peer-reviewed articles with relevant keywords including "cholangitis" and "procalcitonin" from their inception to July 13, 2021. Results: We identified six studies. All the studies employed case-control design and aimed to evaluate the usefulness of serum PCT to predict the severity of AC with key identified outcomes. While potential cut-off values of serum PCT for severe AC ranged from 1.8–3.1 ng/mL, studies used different severity criteria and the definition of urgent biliary decompression. No studies proposed cut-off PCT values for the need for urgent biliary decompression. Conclusion: This scoping review identified that the current level of evidence regarding the usefulness of serum PCT in assessing the severity of AC. Further clinical research is warranted with a focus on standardized outcome measures employing prospective or experimental designs.

The role of MPV/albumin ratio in determining disease severity in acute cholangitis in the emergency medicine

“…Six studies were included in this study. We found that the sample size was lower in all studies than in our study.In all studies, procalcitonin level was found to be higher in severe acute cholangitis patients compared to mild and moderate acute cholangitis patients (23). In our study, similar to the above studies, procalcitonin level was found to be highest in severe acute cholangitis patients, then in moderate acute cholangitis patients and lowest in mild cholangitis patients.…”