Most Read Articles
15 Nov 2017
Both hatha yoga and a low-FODMAP (Fermentable, Oligo-, Di-, Monosaccharides and Polyol) diet can alleviate gastrointestinal symptoms, as well as improve a range of other psychological and physiological health parameters, in patients with irritable bowel syndrome (IBS), a study has shown.
24 Apr 2017

Helicobacter pylori (H. pylori) infection is associated with conditions such as gastritis, peptic ulcer, gastric cancer, and certain types of lymphoma. A common presenting complaint among all these H. pylori-related illnesses is dyspepsia. Dr Desmond Wai from the Desmond Wai Liver and Gastrointestinal Diseases Centre, Mount Elizabeth Novena Specialist Centre, Singapore, speaks on the important role general practitioners (GPs) play in recognizing, diagnosing, and treating H. pylori.

07 Sep 2015
With the incidence of liver disease on the rise, timely and proper intervention is vital, experts say.

ERCP delay of more than 48 hours increases hospital stay of patients with acute cholangitis

09 Jul 2017

Endoscopic retrograde cholangiopancreatography (ERCP) must be performed in patients with acute cholangitis within 2 days of presentation, suggests a recent study, adding that a delay of 48 or more hours may disproportionately increase hospital stay.

Furthermore, a delay of >72 hours is associated with additional adverse outcomes including hypotension requiring vasopressor support.

To define the optimal timing of ERCP for patients with acute cholangitis, researchers prospectively collected clinical data on all cases of cholangitis managed by ERCP from September 2010 to July 2013. They then determined the clinical impact of the time to ERCP, defined as the time from presentation in the emergency department to the commencement of the procedure.

Length of hospitalization was the primary outcome assessed. Secondary outcomes included vasopressor use, endotracheal intubation, intensive care unit (ICU) admission and death.

Of the 199 patients with cholangitis, 182 (92 percent) had a successful ERCP. Patients undergoing ERCP at ≥48 vs <48 hours (median, 9.1 vs 6.5 days; p=0.004) had significantly longer length of hospitalization even though these patients having ERCP at ≥48 hours were less sick as shown by less frequent ICU admission (odds ratio [OR], 0.3; 95 percent CI, 0.2 to 0.6).

Hospitalization increased by 1.44 days for every day ERCP was delayed (p<0.001), according to multivariate analysis. ERCP ≥72 compared with <72 hours indicated ORs of 2.6 (1.0 to 7.0) for vasopressor requirement and 3.6 (0.8 to 15.9) for mortality. Time to ERCP was not associated with procedural adverse events or technical success.

“Acute cholangitis mandates resuscitation, antibiotic therapy and biliary decompression,” researchers said.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
15 Nov 2017
Both hatha yoga and a low-FODMAP (Fermentable, Oligo-, Di-, Monosaccharides and Polyol) diet can alleviate gastrointestinal symptoms, as well as improve a range of other psychological and physiological health parameters, in patients with irritable bowel syndrome (IBS), a study has shown.
24 Apr 2017

Helicobacter pylori (H. pylori) infection is associated with conditions such as gastritis, peptic ulcer, gastric cancer, and certain types of lymphoma. A common presenting complaint among all these H. pylori-related illnesses is dyspepsia. Dr Desmond Wai from the Desmond Wai Liver and Gastrointestinal Diseases Centre, Mount Elizabeth Novena Specialist Centre, Singapore, speaks on the important role general practitioners (GPs) play in recognizing, diagnosing, and treating H. pylori.

07 Sep 2015
With the incidence of liver disease on the rise, timely and proper intervention is vital, experts say.