ASSOCIATION BETWEEN EARLY BILIARY DRAINAGE AND MORTALITY IN PATIENTS WITH ACUTE CHOLANGITIS
Introduction. Acute cholangitis (AC) is a medical condition that needs to be treated right away with biliary drainage (BD), IV fluids, and antibiotics. Prompt use of antibiotics and drainage of the biliary system are essential components of management as per Tokyo Guidelines 2018 [3]. Three principa...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department
2025-05-01
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| Series: | Клінічна та профілактична медицина |
| Subjects: | |
| Online Access: | https://cp-medical.com/index.php/journal/article/view/604 |
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| Summary: | Introduction. Acute cholangitis (AC) is a medical condition that needs to be treated right away with biliary drainage (BD), IV fluids, and antibiotics. Prompt use of antibiotics and drainage of the biliary system are essential components of management as per Tokyo Guidelines 2018 [3]. Three principal drainage procedures are endoscopic biliary drainage (EBD), percutaneous trans-hepatic biliary drainage (PTBD) and surgical biliary drainage [3]. Any delay in diagnosis or initiation of antibiotics and drainage leads to life-threatening consequences. When BD is optimally performed remains uncertain.
Aim. To investigate the effect of biliary drainage timing on clinical outcomes in AC.
Materials and methods. We retrospectively evaluated 389 patients with acute cholangitis who underwent biliary drainage between 2020 and 2024 at the 1st territorial medical association of Lviv, the medical center of St. Paraskeva, the emergency hospital of Chernivtsi.
Results. We found that patients who underwent early biliary drainage (≤ 24 h) had almost no organ failure (p = 0.045), a shorter length of stay in the intensive care units (3.5 vs. 5.05 days, p = 0.040), but no difference in 30-day mortality (p = 0.398) or in-hospital mortality (p = 0.187).
Using 36 hours as a cut-off, there was a difference in 30-day mortality (p = 0.515), ICU length of stay (4.5 vs. 6.5 days, p = 0.210), persistent organ failure (p=0.575) and in-hospital mortality (p = 0.393) among those who had BD before 36 hours.
Conclusions. Our data indicate that early BD performed within 24 hours from hospital admission is associated with lower 30-day mortality, after adjusting for prognostic factors. Therefore, early BD within 24 hours from admission should be considered in patients with AC to reduce mortality. |
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| ISSN: | 2616-4868 |