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Article: Urgent biliary decompression after endoscopic retrograde cholangiopancreatography

TitleUrgent biliary decompression after endoscopic retrograde cholangiopancreatography
Authors
Issue Date1989
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurg
Citation
American Journal Of Surgery, 1989, v. 157 n. 1, p. 121-125 How to Cite?
AbstractAcute cholangitis complicating diagnostic endoscopic retrograde cholangiopancreatography (ERCP) is potentially fatal. Among 323 consecutive patients with proved biliary obstruction, 21 (7 percent) developed acute cholangitis after examination. Four patients underwent emergency surgery for the control of sepsis with two deaths. Of the 21 parameters chosen for evaluation, malignant obstruction, fever (higher than 37.5°C) within 72 hours before the procedure or when afebrile, and an increased aspartate transaminase level of 70 IU or more were the independent predictive factors identified by multivariate analysis. An increased temperature should be regarded as an absolute contraindication to examination unless followed by immediate ductal drainage. Since the risk of septic complications is minimal when none of the risk factors are present, routine urgent biliary decompression after ERCP is probably unnecessary for these selected patients. For patients with malignant obstruction or other risk factors, early elective surgical drainage is advisable. When surgery is not feasible, nonoperative drainage of the obstructed biliary system as a preventive measure might be considered.
Persistent Identifierhttp://hdl.handle.net/10722/172601
ISSN
2015 Impact Factor: 2.403
2015 SCImago Journal Rankings: 1.286
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLai, ECSen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorChoi, TKen_HK
dc.contributor.authorCheng, WKen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2012-10-30T06:23:40Z-
dc.date.available2012-10-30T06:23:40Z-
dc.date.issued1989en_HK
dc.identifier.citationAmerican Journal Of Surgery, 1989, v. 157 n. 1, p. 121-125en_HK
dc.identifier.issn0002-9610en_HK
dc.identifier.urihttp://hdl.handle.net/10722/172601-
dc.description.abstractAcute cholangitis complicating diagnostic endoscopic retrograde cholangiopancreatography (ERCP) is potentially fatal. Among 323 consecutive patients with proved biliary obstruction, 21 (7 percent) developed acute cholangitis after examination. Four patients underwent emergency surgery for the control of sepsis with two deaths. Of the 21 parameters chosen for evaluation, malignant obstruction, fever (higher than 37.5°C) within 72 hours before the procedure or when afebrile, and an increased aspartate transaminase level of 70 IU or more were the independent predictive factors identified by multivariate analysis. An increased temperature should be regarded as an absolute contraindication to examination unless followed by immediate ductal drainage. Since the risk of septic complications is minimal when none of the risk factors are present, routine urgent biliary decompression after ERCP is probably unnecessary for these selected patients. For patients with malignant obstruction or other risk factors, early elective surgical drainage is advisable. When surgery is not feasible, nonoperative drainage of the obstructed biliary system as a preventive measure might be considered.en_HK
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurgen_HK
dc.relation.ispartofAmerican Journal of Surgeryen_HK
dc.subject.meshAcute Diseaseen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshCholangiopancreatography, Endoscopic Retrograde - Adverse Effectsen_US
dc.subject.meshCholangitis - Etiology - Surgeryen_US
dc.subject.meshCholestasis - Surgeryen_US
dc.subject.meshEmergenciesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshRetrospective Studiesen_US
dc.titleUrgent biliary decompression after endoscopic retrograde cholangiopancreatographyen_HK
dc.typeArticleen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailCheng, WK: wkcheng@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityCheng, WK=rp00374en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/0002-9610(89)90431-5-
dc.identifier.pmid2910117en_HK
dc.identifier.scopuseid_2-s2.0-0024496919en_HK
dc.identifier.volume157en_HK
dc.identifier.issue1en_HK
dc.identifier.spage121en_HK
dc.identifier.epage125en_HK
dc.identifier.isiWOS:A1989R771300019-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLai, ECS=36932159600en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridChoi, TK=7202770029en_HK
dc.identifier.scopusauthoridCheng, WK=7404684779en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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