What is the optimal timing for ERCP in severe cholangitis?

Conclusions: ERCP should be performed within 2 days of presentation as a delay of 48 or more hours is associated with disproportionate increase in hospital stay. Delay>72 hours is associated with additional adverse outcomes including hypotension requiring vasopressor support.

What is the treatment of cholangitis?

Early treatment is especially important for acute cholangitis. Your doctor may recommend antibiotics, such as penicillin, ceftriaxone, metronidazole, or ciprofloxacin, for up to 10 days . They may also recommend procedures in the hospital, such as: intravenous (IV) fluids.

How does ERCP cause cholangitis?

Post-ERCP cholangitis is suspected to occur easily if ERCP is performed to the bile duct in type I SOD due to delayed drainage of contrast medium. We have sometimes seen biliary complications after ERCP, such as post-ERCP cholangitis and abnormal liver function with or without biliary type pain.

What is an urgent ERCP?

Emergency ERCP is feasible, safe and effective in critically ill patients with acute severe cholangitis in appropriate settings. Emergency ERCP is successful and results in a good outcome in this cohort of critically ill patients. Emergency ERCP in this cohort of critically ill patients should not be considered futile.

Is cholangitis curable?

There’s no cure for primary biliary cholangitis, but medications are available to help slow the progression of the disease and prevent complications. Options include: Ursodeoxycholic acid (UDCA). This medication, also known as ursodiol (Actigall, Urso), is commonly used first.

When is an ERCP not indicated?

In June 2019, the ASGE issued a guideline for the use of ERCP in the evaluation and management of choledocholithiasis, which included the following recommendations: In patients with gallstone pancreatitis without cholangitis or biliary obstruction/choledocholithiasis, urgent (< 48 hours) ERCP is not recommended.

Is an ERCP an emergency?

Why does ERCP cause cholangitis?

Can ERCP cause ascending cholangitis?

Endoscopic retrograde cholangiopancreatography (ERCP) ERCP can determine the underlying cause of cholangitis and can also be therapeutic, by way of stone extraction and/or stent placement. However, ERCP is invasive and therefore carries much more risk than the imaging modalities mentioned above.