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Cholangitis

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Outcomes following early versus delayed cholecystectomy performed for acute cholangitis.
Discolo A, Reiter S, French B, Hayes D, Lucas G, Tan L, Scanlan J, Martinez R.
Surg Endosc. 2020;34(7):3204-3210.

Rationale for Inclusion: Retrospective review confirming that index admission cholecystectomy is safe and not associated with prolonged OR time or conversion rate, regardless of Tokyo grade over delayed cholecystectomy

CAVEAT: Single center database

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Trends and risk factors for 30-day readmissions in patients with acute cholangitis: analysis from the national readmission database.
Parikh MP, Garg R, Chittajallu V, Gupta N, Sarvepalli S, Lopez R, Thota PN, Siddiki H, Bhatt A, Chahal P, Jang S, Stevens T, Vargo J, McCullough A, Sanaka MR.
Surg Endosc. 2021 Jan;35(1):223-231.

Rationale for Inclusion: Retrospective cohort of the national readmission data from 2010 to 2014 evidencing a 30 day elevated readmission rate for cholangitis and the benefit of early ERCP and cholecystectomy.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Shorter duration of antibiotic treatment for acute bacteraemic cholangitis with successful biliary drainage: a retrospective cohort study.
Doi A, Morimoto T, Iwata K.
Clin Microbiol Infect. 2018 Nov;24(11):1184-1189.

Rationale for inclusion: This single institution retrospective cohort study demostrates that a shorter course of antibiotics, 6 days, had no worse outcomes than a longer course of 12 days for patients with bacteremia and cholangitis.  Antibiotics must be paired with biliary decompression.    

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Outcomes Associated With Timing of ERCP in Acute Cholangitis Secondary to Choledocholithiasis.
Parikh MP, Wadhwa V, Thota PN, Lopez R, Sanaka MR.
J Clin Gastroenterol. 2018 Nov/Dec;52(10):e97-e102.

Rationale for inclusion: This retrospective review from the National Inpatient Survery demonstrates that, in inpatients with cholangitis ERCP should not be delayed beyond 48 hours. 

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Tokyo Guidelines 2018: initial management of acute biliary infection and flowchart for acute cholangitis.
Miura F, Okamoto K, Takada T, Strasberg SM, Asbun HJ, Pitt HA, Gomi H, Solomkin JS, Schlossberg D, Han HS, Kim MH, Hwang TL, Chen MF, Huang WS, Kiriyama S, Itoi T, Garden OJ, Liau KH, Horiguchi A, Liu KH, Su CH, Gouma DJ, Belli G, Dervenis C, Jagannath P, Chan ACW, Lau WY, Endo I, Suzuki K, Yoon YS, de Santibañes E, Giménez ME, Jonas E, Singh H, Honda G, Asai K, Mori Y, Wada K, Higuchi R, Watanabe M, Rikiyama T, Sata N, Kano N, Umezawa A, Mukai S, Tokumura H, Hata J, Kozaka K, Iwashita Y, Hibi T, Yokoe M, Kimura T, Kitano S, Inomata M, Hirata K, Sumiyama Y, Inui K, Yamamoto M.
J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):31-40

Rationale for inclusion: Updates TG13 on flowchart for treatment startified by disease severity.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis.
Gomi H, Solomkin JS, Schlossberg D, Okamoto K, Takada T, Strasberg SM, Ukai T, Endo I, Iwashita Y, Hibi T, Pitt H, Matsunaga N, Takamori Y, Umezawa A, Asai K, Suzuki K, Han HS, Hwang TL, Mori Y, Yoon YS, Huang WS, Belli G, Dervenis C, Yokoe M, Kiriyama S, Itoi T, Jagannath P, Garden OJ, Miura F, de Santibañes E, Shikata S, Noguchi Y, Wada K, Honda G, Supe AN, Yoshida M31, Mayumi T, Gouma DJ, Deziel DJ, Liau KH, Chen MF, Liu KH, Su CH, Chan ACW, Yoon DS, Choi IS, Jonas E, Chen XP, Fan ST, Ker CG, Giménez ME, Kitano S, Inomata M, Mukai S, Higuchi R, Hirata K, Inui K, Sumiyama Y, Yamamoto M.
J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):3-16

Rationale for inclusion: Updates TG13 on antibiotic therapy

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Association between early ERCP and mortality in patients with acute cholangitis.
Tan M, Schaffalitzky de Muckadell OB, Laursen SB.
Gastrointest Endosc. 2018 Jan;87(1):185-192.

Rationale for inclusion: This retrospective review (over 7 yrs  & over 400 patients) of a single Danish center provides the first association between early ERCP (within 24hrs) and lower  mortality.

CAVEAT: The majority of the patients had malignancy.

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Optimal Timing of Endoscopic Retrograde Cholangiopancreatography in Acute Cholangitis
Hou LA, Laine L, Motamedi N, Sahakian A, Lane C, Buxbaum J.
J Clin Gastroenterol. 2017 Jul;51(6):534-538.

Rationale for inclusion: This large prospective series demostrates that delays more than 48 hrs in ERCP have an increase in length LOS.

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Procalcitonin is a useful biomarker to predict severe acute cholangitis: a single-center prospective study
Umefune G, Kogure H, Hamada T, Isayama H, Ishigaki K, Takagi K, Akiyama D, Watanabe T, Takahara N, Mizuno S, Matsubara S, Yamamoto N, Nakai Y, Tada M, Koike K.
J Gastroenterol. 2017 Jun;52(6):734-745

Rationale for inclusion: This study shows that procalcitonin levels could be used to stratify the severity of cholangitis and predicts the need for early decompression.

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Delayed endoscopic retrograde cholangiopancreatography is associated with persistent organ failure in hospitalised patients with acute cholangitis.
Lee F, Ohanian E, Rheem J, Laine L, Che K, Kim JJ.
Aliment Pharmacol Ther. 2015 Jul;42(2):212-20.

Rationale for inclusion: Delay in the management of acute cholangitis can increase morbidity and mortality. The ability to decompress via ERCP improves outcome. The authors demonstrate that a delay of >48 hours in performing ERCP even with ongoing antibiotic treatment, worsened outcome thereby emphasizing the need for timely intervention with these patients. 

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Evaluation of Antibiotic Use to Prevent Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis and Cholangitis.
Ishigaki T, Sasaki T, Serikawa M, Kobayashi K, Kamigaki M, Minami T, Okazaki A, Yukutake M, Ishii Y, Kosaka K, Mouri T, Yoshimi S, Chayama K.
Hepatogastroenterology. 2015 Mar-Apr;62(138):417-24.

Rationale for inclusion: The authors conclude that addition of prophylactic antibiotics do not reduce risk of cholangitis after ERCP.

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TG13 antimicrobial therapy for acute cholangitis and cholecystitis.
Gomi H, Solomkin JS, Takada T, Strasberg SM, Pitt HA, Yoshida M, Kusachi S, Mayumi T, Miura F, Kiriyama S, Yokoe M, Kimura Y, Higuchi R, Windsor JA, Dervenis C, Liau KH, Kim MH; Tokyo Guideline Revision Committee.
J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):60-70.

Rationale for inclusion: This 2013 Tokyo Guidelines update provides recommendations for antimicrobial therapy.

 

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

TG13 flowchart for the management of acute cholangitis and cholecystitis.
Miura F, Takada T, Strasberg SM, Solomkin JS, Pitt HA, Gouma DJ, Garden OJ, Büchler MW, Yoshida M, Mayumi T, Okamoto K, Gomi H, Kusachi S, Kiriyama S, Yokoe M, Kimura Y, Higuchi R, Yamashita Y, Windsor JA, Tsuyuguchi T, Gabata T, Itoi T, Hata J, Liau KH; Tokyo Guidelines Revision Committee.
J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):47-54.

 Rationale for inclusion: This 2013 Tokyo Guidelines update provides a flowchart for the recommended treatment of acute cholangitis stratified by disease severity.

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New diagnostic criteria and severity assessment of acute cholangitis in revised Tokyo Guidelines.
Kiriyama S, Takada T, Strasberg SM, Solomkin JS, Mayumi T, Pitt HA, Gouma DJ, Garden OJ, Büchler MW, Yokoe M, Kimura Y, Tsuyuguchi T, Itoi T, Yoshida M, Miura F, Yamashita Y, Okamoto K, Gabata T, Hata J, Higuchi R, Windsor JA, Bornman PC, Fan ST, Singh H, de Santibanes E, Gomi H, Kusachi S, Murata A, Chen XP, Jagannath P, Lee S, Padbury R, Chen MF; Tokyo Guidelines Revision Committee.
J Hepatobiliary Pancreat Sci. 2012 Sep;19(5):548-56.

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Rationale for inclusion: This Tokyo Guidelines 2013 update provides a good evidence-based review of the diagnostic criteria and severity assessment of acute cholangitis.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Endoscopic biliary drainage for severe acute cholangitis.
Lai EC, Mok FP, Tan ES, Lo CM, Fan ST, You KT, Wong J.
N Engl J Med. 1992 Jun 11;326(24):1582-6.

Rationale for inclusion: This RCT is widely cited as the evidence-base supporting initial endoscopic CBD clearance (as opposed to surgery) for patients with acute cholangitis.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

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