Timing of biliary decompression for acute cholangitis

Abstract

Severe acute cholangitis (AC) exacerbates the risk of death because of the rapid progression of the disease. The optimal timing of biliary decompression (BD) as a necessary intervention in patients with severe AC is controversial. A recently report titled “Timing of endoscopic retrograde cholangiopancreatography in the treatment of acute cholangitis of different severity” in the World Journal of Gastroenterology that the optimal time of endoscopic retrograde cholangiopancreatography for treating patients with severe AC is ≤ 48 but not ≤ 24 h, providing clinical evidence for selecting the optimal time for implementation of BD. Here, we discuss the controversy over the optimal timing of BD for AC based on guidelines and clinical evidence, and consider that more high-level clinical researches are urgent needed to benefit the management of patients with different severity of AC.

Advancements in metabolomics research in benign gallbladder diseases: A review

“…The chemical shifts or mass-to-charge ratios of these peaks can exhibit significant variations. [39,43,44]…”

“…The prognosis of acute cholangitis is of paramount importance. Zhang et al [44] used chemiluminescence enzyme immunoassay and ultra-high performance liquid chromatography-mass spectrometry to measure procalcitonin and plasma acylcarnitines in the blood of patients with acute cholangitis. They found that the concentrations of procalcitonin, short-chain acylcarnitines, and medium-chain acylcarnitines increased with disease severity, whereas the concentration of long-chain acylcarnitines decreased.…”

“…In conclusion, procalcitonin may serve as a specific indicator for predicting the severity of acute cholangitis and the need for biliary drainage, whereas acetyl-L-carnitine may be a potential prognostic factor for patients with acute cholangitis (Table 1). [44]…”

Comparison Among Presepsin, Procalcitonin, and C-Reactive Protein in Predicting Blood Culture Positivity and Pathogen in Sepsis Patients

“…In this retrospective, multicentre study, a dataset of prospectively enrolled patients with sepsis in the emergency, intensive care unit, and infectious disease departments of five university-affiliated teaching hospitals in China between November 2017 and June 2021 was analyzed (20,21). This study was approved by the Beijing Friendship Hospital Ethics Committee (approval number: 2022-P2-029-01).…”