Evidence map›Paper›PMID 42029962›Full record

ArticleDigestive diseases and sciences2026

Same-Admission Cholecystectomy Is Safe and Effective for Patients with Concurrent Choledocholithiasis and Cholangitis.

Aditya Chandrashekar, Arpita N Jajoo, Jianing Li, Romik Srivastava, Amukta Palakurthi, Sukhmanpreet Kaur Sandhu, Ivy Mannoh, Grace Rozycki, Alistair J Kent, Venkata S Akshintala

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Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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10 authors.

Aditya ChandrashekarDivision of Gastroenterology, Johns Hopkins Hospital, 600 N. Wolfe St., Blalock 411, Baltimore, MD, USA.
Arpita N JajooDivision of Gastroenterology, Johns Hopkins Hospital, 600 N. Wolfe St., Blalock 411, Baltimore, MD, USA.
Jianing LiDivision of Gastroenterology, Johns Hopkins Hospital, 600 N. Wolfe St., Blalock 411, Baltimore, MD, USA.
Romik SrivastavaDivision of Gastroenterology, Johns Hopkins Hospital, 600 N. Wolfe St., Blalock 411, Baltimore, MD, USA.
Amukta PalakurthiDivision of Gastroenterology, Johns Hopkins Hospital, 600 N. Wolfe St., Blalock 411, Baltimore, MD, USA.
Sukhmanpreet Kaur SandhuDivision of Gastroenterology, Johns Hopkins Hospital, 600 N. Wolfe St., Blalock 411, Baltimore, MD, USA.
Ivy MannohDepartment of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Grace RozyckiDepartment of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Alistair J KentDepartment of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Venkata S AkshintalaDivision of Gastroenterology, Johns Hopkins Hospital, 600 N. Wolfe St., Blalock 411, Baltimore, MD, USA. vakshin1@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAlthough guidelines recommend early cholecystectomy (CCY) after ERCP for choledocholithiasis-associated cholangitis, surgery is frequently deferred, particularly in severe disease. We evaluated real-world outcomes and decision-making between same-admission versus deferred CCY to assess the impact of surgical delay.

methodsWe conducted a retrospective cohort study on patients with choledocholithiasis-associated cholangitis from 2011 to 2022. Primary outcomes were the occurrence of ≥ 1 recurrent biliary event (RBE) within one year, and 30-day mortality and readmissions. Secondary outcomes included operative complications, length of stay, and reasons for delay. Multivariable logistic regression adjusted for age, comorbidities, sex, and severity, with subgroup analyses for Grade III cholangitis. Kaplan-Meier survival analysis evaluated time to first RBE.

resultsAmong 171 patients (mean [SD] age, 66.2 [19.1] years; 85 [49.7%] female), 94 (55%) had CCY deferred. Same-admission CCY was associated with lower odds of RBEs (aOR 0.01; 95% CI 0-0.08; p < 0.001) and 30-day readmission (1.3% vs. 13.8%; aOR 0.11; 95% CI 0.01-0.48; p = 0.0023), with similar complication rates and length of stay. Kaplan-Meier analysis confirmed superior RBE-free survival for same-admission CCY (log-rank p < 0.001). Among patients with Grade III cholangitis (n = 34), same-admission CCY reduced RBE rate (0% vs. 56.5%; p < 0.001) without increasing intraoperative or postoperative complications. Deferral was most often due to high surgical risk (21.3%), concurrent pathology (20.2%), or patient preference (14.9%).

conclusionsSame-admission CCY for choledocholithiasis-associated acute cholangitis reduced recurrence and 30-day readmission without increasing postoperative complications, mortality, or length of stay, including in Grade III cholangitis. These findings support same-admission CCY after clinical stabilization.

Indexed as

CholangitisCholecystectomyCholedocholithiasisPatient AdmissionAgedCholangiopancreatography, Endoscopic RetrogradeFemaleHumansLength of StayMaleMiddle AgedPatient ReadmissionPostoperative ComplicationsRecurrenceRetrospective StudiesTime-to-TreatmentCholangitisCholecystectomyCholedocholithiasisEndoscopic retrograde cholangiopancreatography (ERCP)

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PMID42029962

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.