ASGE guideline on the management of cholangitis.

Published on Aug 1, 2021in Gastrointestinal Endoscopy9.427
· DOI :10.1016/J.GIE.2020.12.032
James Buxbaum26
Estimated H-index: 26
(SC: University of Southern California),
Carlos Buitrago1
Estimated H-index: 1
(SC: University of Southern California)
+ 21 AuthorsSachin Wani71
Estimated H-index: 71
(Anschutz Medical Campus)
Cholangitis is a GI emergency requiring prompt recognition and treatment. The purpose of this document from the American Society for Gastrointestinal Endoscopy's (ASGE) Standards of Practice Committee is to provide an evidence-based approach for management of cholangitis. This document addresses the modality of drainage (endoscopic vs percutaneous), timing of intervention ( 48 hours), and extent of initial intervention (comprehensive therapy vs decompression alone). Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to formulate recommendations on these topics. The ASGE suggests endoscopic rather than percutaneous drainage and biliary decompression within 48 hours. Additionally, the panel suggests that sphincterotomy and stone removal be combined with drainage rather than decompression alone, unless patients are too unstable to tolerate more extensive endoscopic treatment.
#1Umair IqbalH-Index: 13
#2Harshit S. Khara (Geisinger Medical Center)H-Index: 12
Last. Matthew Shellenberger (The Commonwealth Medical College)H-Index: 4
view all 8 authors...
Abstract Background and Aims Acute cholangitis (AC) is characterized by abdominal pain, fever, and jaundice. The majority of the patients respond to medical management with intravenous hydration and antibiotics. Almost 20% to 30% require biliary drainage, and ERCP is the procedure of choice. We conducted a systematic review and meta-analysis to evaluate the impact of emergent biliary drainage on patients' outcomes. Methods A comprehensive literature review was conducted by searching the Embase a...
#1Ramzi Mulki (Emory University)H-Index: 6
#2Rushikesh Shah (Emory University)H-Index: 8
Last. Emad Qayed (Emory University)H-Index: 10
view all 3 authors...
Early vs late endoscopic retrograde cholangiopancreatography in patients with acute cholangitis: A nationwide analysis
#1Malav P. Parikh (SHM: Society of Hospital Medicine)H-Index: 8
#2Vaibhav WadhwaH-Index: 12
Last. Madhusudhan R. Sanaka (Cleveland Clinic)H-Index: 28
view all 5 authors...
GOALS: To determine the outcomes associated with timing of endoscopic retrograde cholangiopancreatography (ERCP) in patients with acute cholangitis due to choledocholithiasis, from a population-based study. BACKGROUND: Although ERCP is the cornerstone in the management of patients with acute cholangitis due to choledocholithiasis, the effect of timing of ERCP on health care outcomes is not well known. MATERIALS AND METHODS: In this retrospective study, national inpatient sample (NIS) data were u...
#1Ryunosuke Hakuta (UTokyo: University of Tokyo)H-Index: 10
#2Tsuyoshi Hamada (UTokyo: University of Tokyo)H-Index: 43
Last. Kazuhiko Koike (UTokyo: University of Tokyo)H-Index: 94
view all 16 authors...
Background Biliary drainage via endoscopic retrograde cholangiopancreatography (ERCP) is the first-line treatment for acute cholangitis. Despite the established effectiveness of urgent biliary drainage in patients with severe acute cholangitis, the indication of this procedure for non-severe acute cholangitis is controversial.
#1Sachin WaniH-Index: 71
#2Shahnaz SultanH-Index: 45
Last. Karen WoodsH-Index: 16
view all 7 authors...
#1Akira YamamiyaH-Index: 4
#2Katsuya KitamuraH-Index: 11
Last. Hitoshi Yoshida (Showa University)H-Index: 13
view all 6 authors...
Feasibility of initial endoscopic common bile duct stone removal in patients with acute cholangitis
#1Linda A. Hou (UCLA: University of California, Los Angeles)H-Index: 1
#2Loren LaineH-Index: 88
Last. James BuxbaumH-Index: 26
view all 6 authors...
Acute cholangitis mandates resuscitation, antibiotic therapy, and biliary decompression. Our aim was to define the optimal timing of endoscopic retrograde cholangiopancreatography (ERCP) for patients with acute cholangitis. Clinical data on all cases of cholangitis managed by ERCP were prospectively collected from September 2010 to July 2013. The clinical impact of the time to ERCP, defined as the time from presentation in the emergency department to the commencement of the ERCP, was determined....
#1Chan Sun Park (CBNU: Chungbuk National University)H-Index: 2
#2Hee Seok Jeong (CBNU: Chungbuk National University)H-Index: 2
Last. Seon Mee Park (CBNU: Chungbuk National University)H-Index: 19
view all 7 authors...
Background Acute cholangitis in old people is a cause of mortality and prolonged hospital stay. We evaluated the effects of methods and timing of biliary drainage on the outcomes of acute cholangitis in elderly and very elderly patients. Methods We analyzed 331 patients who were older than 75 years and were diagnosed with acute calculous cholangitis. They were admitted to our hospital from 2009 to 2014. Patients' demographics, severity grading, methods and timing of biliary drainage, mortality, ...
#1Wichor M. Bramer (EUR: Erasmus University Rotterdam)H-Index: 33
#2Dean Giustini (UBC: University of British Columbia)H-Index: 18
Last. Tanja Bekhuis (University of Pittsburgh)H-Index: 13
view all 5 authors...
When conducting exhaustive searches for systematic reviews, information professionals search multiple databases with overlapping content [1–4]. They typically remove duplicate records to reduce the reviewers' workload associated with screening titles and abstracts; sometimes the reviewers remove the duplicates. Several articles have been published recently on de-duplication methods. In the authors' opinion, these methods are either very time consuming [5] or impractical, as they require uploadin...
#1Constantine J. Karvellas (U of A: University of Alberta)H-Index: 33
#2Juan G. Abraldes (U of A: University of Alberta)H-Index: 76
Last. Aseem Kumar (UM: University of Manitoba)H-Index: 38
view all 8 authors...
SummaryBackground Cholangitis-associated septic shock carries significant mortality. There is uncertainty regarding the most appropriate time to achieve biliary decompression. Aim To determine whether the timing of biliary decompression and anti-microbial therapy affect the survival in cholangitis patients with septic shock. Methods Nested retrospective cohort study of all cholangitis-associated septic shock patients (hypotension requiring vasopressors) from an international, multi-centre databa...
Cited By1
#1James Buxbaum (SC: University of Southern California)H-Index: 26
#2Bashar J. Qumseya (UF: University of Florida)H-Index: 22
Last. Sachin Wani (Anschutz Medical Campus)H-Index: 71
view all 3 authors...
Abstract BACKGROUND AND AIMS Despite improvements in imaging and laboratory medicine, consensus criteria for the diagnosis of cholangitis are lacking. Although endoscopic retrograde cholangiopancreatography (ERCP) is an effective treatment for cholangitis, it should be reserved for those patients with a high probability of the diagnosis, given the morbidity associated with the procedure. METHODS A comprehensive literature search of PubMed (coverage 1898-present), Web of Science (1900-July 15, 20...
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.