SynthesisClinical and translational gastroenterology2020
Timing of Performing Endoscopic Retrograde Cholangiopancreatography and Inpatient Mortality in Acute Cholangitis: A Systematic Review and Meta-Analysis.
Synthesis in Clinical and translational gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Antibiotic Therapy of 3 Days May Be Sufficient After Biliary Drainage for Acute Cholangitis: A Systematic Review.Digestive diseases and sciences · 2021Pooled it
- Association of ERCP Timing with Clinical Outcomes in Acute Cholangitis Secondary to Choledocholithiasis: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Timing of Biliary Drainage and Clinical Outcomes in Acute Cholangitis: A Single-Center Retrospective Cohort Study.Cureus · 2026Article
- Safety and efficacy of single-stage endoscopic stone removal and the timing of ERCP for acute cholangitis: a multicenter study.BMC gastroenterology · 2026Article
- Strasberg severity predicts 30-day loss of bile duct patency after ERCP in post-cholecystectomy bile duct injury.Gastroenterology and hepatology from bed to bench · 2026Article
- ERCP Performed Out-of-Working Hours Is Effective and Reliable for the Treatment of Acute Cholangitis.Gastroenterology research and practice · 2026Article
- Urgent endoscopic retrograde cholangiopancreatography improves clinical outcomes in acute cholangitis from choledocholithiasis: a propensity score-matched study.Surgical endoscopy · 2025Article
- Does out of Hours Endoscopic Retrograde Cholangiopancreatography Lead to Higher Pancreatitis and Hospitalization Rates?ANZ journal of surgery · 2025Article
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- Unsedated emergent ERCP is feasible and efficient for acute cholangitis in old patients over 80 years.Surgical endoscopy · 2025Article
- Acute cholangitis: Does malignant biliary obstructionWorld journal of clinical cases · 2023Article
- Early Management of Severe Biliary Infection in the Era of the Tokyo Guidelines.Journal of clinical medicine · 2023Review
- Identification of Microbial Species and Analysis of Antimicrobial Resistance Patterns in Acute Cholangitis Patients with Malignant and Benign Biliary Obstructions: A Comparative Study.Medicina (Kaunas, Lithuania) · 2023Article
- Characteristics and clinical outcomes of acute cholangitis in older patients.European geriatric medicine · 2023Article
- Timing of biliary decompression for acute cholangitis.World journal of gastroenterology · 2023Article
- Timing of endoscopic retrograde cholangiopancreatography in the treatment of acute cholangitis of different severity.World journal of gastroenterology · 2022Article
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- Performance of diagnostic tools for acute cholangitis in patients with suspected biliary obstruction.Journal of hepato-biliary-pancreatic sciences · 2022Article
- Systematic Review: Impact of Social Determinants of Health on the Management and Prognosis of Gallstone Disease.Health equity · 2022Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAlthough early biliary drainage improves outcomes in patients with acute cholangitis, the optimal time to perform endoscopic retrograde cholangiopancreatography (ERCP) is controversial. Our aim was to evaluate the impact of timing of ERCP on mortality in hospitalized patients with acute cholangitis.
methodsWe searched PubMed, EMBASE, and The Cochrane Library (until February 2019) for studies evaluating the impact of timing of ERCP (<24, <48, and <72 hours from hospitalization) on outcomes in patients with acute cholangitis. The primary outcome was in-hospital mortality.
resultsFourteen observational studies, including 84,063 patients (mean age = 66 ± 18), met the study criteria. The overall pooled in-hospital mortality with acute cholangitis was 1.9% (95% confidence interval [CI] 1.8%-7.6%), which increased to 4.3% (95% CI 1.8%-8.7%) when administrative database studies were excluded. In 9 studies, ERCP performed <24 compared with ≥24 hours decreased in-hospital mortality (odds ratio [OR] = 0.81, 95% CI 0.73-0.90; I = 0%). In 8 studies, ERCP performed <48 compared with ≥48 hours decreased in-hospital mortality (OR = 0.57, 95% CI 0.51-0.63; I = 0%). In 4 studies, ERCP performed <72 compared with ≥72 hours decreased in-hospital mortality (OR = 0.32, 95% CI 0.15-0.68; I = 0%). Furthermore, hospital stay was reduced in patients receiving ERCP <24 compared with ≥24 hours (mean difference [MD] = 3.2 days, 95% CI 2.3-4.1; I = 78%), <48 compared with ≥48 hours (MD = 3.6 days, 95% CI 2.1-5.1; I = 98%), and <72 compared with ≥72 hours (MD = 4.1 days, 95% CI 0.9-7.3; I = 63%). DISCUSSION: In observational studies, earlier ERCP performed in patients with acute cholangitis, even urgently performed <24 hours from presentation, was associated with reduced mortality. A randomized trial evaluating the impact of urgent ERCP on outcomes is needed.
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