Timing of Admission and Endoscopic Drainage in Patients With Acute Cholangitis: Weekday Versus Weekend

Aims Acute cholangitis is a complication secondary to biliary obstruction and endoscopic retrograde cholangiopancreatography (ERCP) is the first-line procedure that can ensure biliary drainage. We aimed to determine the association between timing of hospital admission, ERCP (procedure day), length of hospital stay (LOHS) and mortality in patients diagnosed with acute cholangitis. Methods We retrospectively investigated 128 patients with acute cholangitis between June 2018 and December 2020 at the Gastroenterology Department of the Timis Emergency County Hospital, Romania. All patients underwent ERCP. Patients were divided in two groups according to the timing of hospital admission, weekdays (WD) and weekend (WE) days group. We assessed their severity according to the 2018 Tokyo Guideline (TG18) criteria, and we analyzed the outcomes of mortality and length of hospital stay (LOHS). Results A total of 128 patients were included in this study, with a mean age of 69.5 ± 14.1 years old. The male to female ratio was 1.06. The majority of them, 51.6 % (66/128), had a benign obstruction. According to TG18, more than half of the patients (52.3 %) had grade II (moderate) cholangitis and 31/128 (24.2 %) patients had grade III (severe) cholangitis. Admission rate was significantly higher in the WD group compared to WE group, 64.8 % vs. 35.2 %, (p<0.001). Early ERCP (< 48 hours) was performed in 63/83 (75.9 %) of patients from the WD group compared to 19/45 (42.2 %) from the WE group (p<0.001). Late ERCP (>72 hours) had a significantly higher rate in the WE group compared to the WD group, 25/45 (55.6 %) vs. 17/83 (20.8 %), p = 0.0001. LOHS was higher for patients admitted during weekend, but the mortalilty rate had no statistically significant differences among the two groups. Conclusions Timing of admission in patients for acute cholangitis is associated with LOHS, but not with inpatient mortality. Early ERCP predicts a shorter LOHS. Citation: Burciu C, Sporea I, Ratiu I et al. OP116 TIMING OF ADMISSION AND ENDOSCOPIC DRAINAGE IN PATIENTS WITH ACUTE CHOLANGITIS: WEEKDAY VERSUS WEEKEND. Endoscopy 2021; 53: S49. Publication History Publication Date: 19 March 2021 (online) © 2021. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany