Safety of immediate endoscopic sphincterotomy in acute suppurative cholangitis caused by choledocholithiasis

Table 1 Characteristics of patients undergoing emergency endoscopic retrograde cholangiopancreatography

	Immediate EST group (n = 59)	Elective EST group (n = 28)	P value
Sex (M:F)	31:28	13:15	0.59
Age (mean ± SD, range)	68.76 ± 14.58	78.82 ± 9.07	0.0001
Clinical presentation, n (%)
Peritonism	51 (86)	19 (68)	0.04
Fever	28 (47)	15 (54)	0.59
Hypotension	1 (1.6)	1 (3.5)	0.54
Altered sensorium	1 (1.6)	0 (0)	0.67
Pre-existing pancreatitis (%)	15 (25)	1 (3.5)	0.01
WBC	10959 ± 5857	10025 ± 4110	0.39
Plt	20.4 ± 8.0	18.5 ± 6.3	0.26
PT (%)	86.7 ± 15.8	72.7 ± 22.2	0.009
CRP	5.32 ± 5.59	7.84 ± 6.76	0.069
T-Bil	4.09 ± 2.8	3.9 ± 2.5	0.76
AST	253.3 ± 215.2	262.3 ± 370.3	0.90
ALT	243.5 ± 182	262.3 ± 278.7	0.83
γGTP	458.6 ± 326.7	453.4 ± 233.6	0.82
ALP	760.1 ± 404.9	826.3 ± 608.4	0.60

CRP: C-reactive protein; EST: Endoscopic sphincterotomy; WBC: White blood cells; Plt: Blood platelet; T-Bil: Serum total bilirubin; AST: Aspartate aminotransferase; ALT: Glutamic-pyruvic transaminase; ALP: Alkalinephosphatase; γGTP: Serum gamma gamma glutamyl transpeptidase.

Table 2 Demographic data of patients before endoscopic sphincterotomy

	Immediate EST group	Elective EST group	P value
WBC	10959 ± 5857	6521 ± 2274	0.0002
Plt	20.4 ± 8.0	32.6 ± 42.2	0.03
PT (%)	86.7 ± 15.8	82.9 ± 14.1	0.23
CRP	5.32 ± 5.59	1.82 ± 1.65	0.0017
T-Bil	4.09 ± 2.8	1.4 ± 1.0	< 0.0001
AST	253.3 ± 215.2	50.6 ± 53.5	< 0.0001
ALT	243.5 ± 182	66.9 ± 55.3	< 0.0001
γGTP	458.6 ± 326.7	254.3 ± 230.3	< 0.0001
ALP	760.1 ± 404.9	494.5 ± 241.7	< 0.0001

CRP: C-reactive protein; EST: Endoscopic sphincterotomy; WBC: White blood cells; Plt: Blood platelet; T-Bil: Serum total bilirubin; AST: Aspartate aminotransferase; ALT: Glutamic-pyruvic transaminase; ALP: Alkalinephosphatase; γGTP: Serum gamma gamma glutamyl transpeptidase.

Table 3 Outcome of patients subjected to endoscopic retrograde cholangiopancreatography

		Elective EST group (n = 28)	P value
Immediate EST group (n = 59)
Normalization of body temperature	1.37 ± 1.86	1.68 ± 2.83	0.6
Normalization of WBC	2.19 ± 2.87	1.39 ± 1.13	0.06
Normalization of CRP	9.12 ± 7.73	13.75 ± 9.32	0.017
Time to discharge	16.79 ± 11.89	21.75 ± 14.1	0.09
Immediate EST with stone extraction group (n = 18)
Normalization of body temperature	1.61 ± 0.98	1.68 ± 2.83	0.92
Normalization of WBC	1.78 ± 0.9	1.39 ± 1.13	0.53
Normalization of CRP	7.0 ± 5.7	13.75 ± 9.32	0.008
Time to discharge	13.2 ± 7.5	21.75 ± 14.1	0.02

CRP: C-reactive protein; EST: Endoscopic sphincterotomy; WBC: White blood cells.