Liu KT, Lee MH, Lin CH, Tsou YK, Sung KF, Wang SF, Wu CH, Liu NJ. Acute cholangitis due to common bile duct stones: Clinical outcomes in patients with and without concurrent acute pancreatitis. World J Clin Cases 2025; 13(32): 110553 [DOI: 10.12998/wjcc.v13.i32.110553]
Corresponding Author of This Article
Yung-Kuan Tsou, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, No. 5 Fu-Shin Street, Kweishan, Taoyuan 333, Taiwan. flying@adm.cgmh.org.tw
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Gastroenterology & Hepatology
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Retrospective Cohort Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 16, 2025 (publication date) through Nov 15, 2025
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World Journal of Clinical Cases
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Liu KT, Lee MH, Lin CH, Tsou YK, Sung KF, Wang SF, Wu CH, Liu NJ. Acute cholangitis due to common bile duct stones: Clinical outcomes in patients with and without concurrent acute pancreatitis. World J Clin Cases 2025; 13(32): 110553 [DOI: 10.12998/wjcc.v13.i32.110553]
World J Clin Cases. Nov 16, 2025; 13(32): 110553 Published online Nov 16, 2025. doi: 10.12998/wjcc.v13.i32.110553
Acute cholangitis due to common bile duct stones: Clinical outcomes in patients with and without concurrent acute pancreatitis
Kuan-Ting Liu, Mu-Hsien Lee, Cheng-Hui Lin, Yung-Kuan Tsou, Kai-Feng Sung, Sheng Fu Wang, Chi-Huan Wu, Nai-Jen Liu
Kuan-Ting Liu, Mu-Hsien Lee, Yung-Kuan Tsou, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
Cheng-Hui Lin, Kai-Feng Sung, Chi-Huan Wu, Nai-Jen Liu, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
Sheng Fu Wang, Department of Gastroenterology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
Author contributions: Liu KT contributed to conceptualization of the study and original manuscript; Lee MH, Lin CH contributed to data planning, interpretation and formal analysis; Tsou YK is committed to conceptualization of the study and manuscript writing-review and editing; Sung KF, Wang SF, and Wu CH contributed to data collection; Liu NJ contributed to revise the final version of the manuscript for submission.
Institutional review board statement: This study was approved in advance by the Institutional Review Board of Chang Gung Memorial Hospital (Approval Number 202500120B0).
Informed consent statement: Since this study was a retrospective study utilizing routine clinical treatment and diagnostic medical records and did not include cases involving HIV infection, the Chang Gung Medical Foundation Institutional Review Board waived the requirement for participant consent.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement–checklist of items, and the manuscript was prepared and revised according to the STROBE Statement–checklist of items.
Data sharing statement: Deidentified individual participant data are available and will be provided upon reasonable request to the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yung-Kuan Tsou, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, No. 5 Fu-Shin Street, Kweishan, Taoyuan 333, Taiwan. flying@adm.cgmh.org.tw
Received: June 10, 2025 Revised: August 8, 2025 Accepted: September 12, 2025 Published online: November 16, 2025 Processing time: 156 Days and 20 Hours
Abstract
BACKGROUND
Patients with concurrent acute biliary pancreatitis (ABP) and acute cholangitis (AC) may experience exacerbated clinical consequences due to bile duct stones. However, studies exploring this topic remain limited.
AIM
To compare the clinical presentation and outcomes of patients experiencing AC with and without ABP.
METHODS
This single-center retrospective cohort study included 358 patients with AC who underwent endoscopic retrograde cholangiopancreatography (ERCP) between January 2016 and December 2017. Patients were divided into two groups: AC with ABP (n = 90) and AC without ABP (n = 268). Clinical characteristics, laboratory data, ERCP results, primary study outcome [intensive care unit (ICU) admission], and secondary outcomes including 30-day mortality, length of hospital stay, and 30-day readmission rate were analyzed and compared.
RESULTS
All patients in the AC with ABP group had interstitial pancreatitis. The AC with ABP group had significantly higher white cell count (WBC) counts (13.1 × 10³/µL vs 10.4 × 10³/µL, P = 0.007) and more abnormal WBC results (61.1% vs 42.3%, P = 0.015). Liver biochemical tests, AC severity, ERCP success, adverse events, ICU admissions, 30-day mortality, hospital stay, and readmission rates did not differ significantly between the two groups. Univariate analysis showed no significant link between concurrent ABP and ICU admission, although significance was marginal in moderate/severe ABP cases (P = 0.051). In the multivariate analysis, age (P = 0.035) and cardiovascular dysfunction (P < 0.001) were independently associated with length of ICU stay.
CONCLUSION
Concurrent interstitial ABP and AC did not significantly affect outcomes. Age and cardiovascular dysfunction were stronger predictors of ICU admission and should guide clinical monitoring and management.
Core Tip: Concurrent acute cholangitis (AC) and acute biliary pancreatitis resulted in significantly higher white cell count (WBC) counts and abnormal WBC counts, suggesting a more intense inflammatory response. However, liver biochemical indices, AC severity, endoscopic retrograde cholangiopancreatography success or adverse events, and primary and secondary outcome measures did not differ significantly between the two groups. Multivariate analysis showed that age and cardiovascular dysfunction were independent factors for intensive care unit admission. Therefore, the presence of acute biliary pancreatitis in patients with AC does not appear to have a significant impact on intensive care unit admission rates or other major clinical outcomes.
