Endoscopy 2020; 52(S 01): S290
DOI: 10.1055/s-0040-1704921
ESGE Days 2020 ePoster presentations
Colon and rectum 09:00–17:00 Thursday, April 23, 2020 ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

CLINICAL SIGNIFICANCE OF BILE JUICE AND UPPER GASTROINTESTINAL ENDOSCOPIC FINDINGS, BEFORE PERFORMING ERCP

K Ryu
1   Konyang University Hospital, Gastroenterology, Daejeon, Korea, Republic of
,
C Im
1   Konyang University Hospital, Gastroenterology, Daejeon, Korea, Republic of
,
M Kang
2   Dankook University Hospital, Internal medicine, Cheonan, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims An impacted bile duct stone is a risk factor for developing acute suppurative cholangitis (ASC). No study has classified biliary obstruction caused by impacted bile duct stones into complete and incomplete obstruction. Complete obstruction would show no bile juice on esophagogastroduodenoscopy (EGD), and it is more likely to be accompanied with ASC than with incomplete obstruction.

    Methods We evaluated 191 patients who underwent EGD within 24 hours before endoscopic retrograde cholangiopancreatography (ERCP) for acute calculous cholangitis from January 2012 to August 2016 at Konyang University Hospital. Patients were divided into groups: bile juice present in the stomach or duodenum on EGD (bile (+) group) and no bile juice present (bile (-) group). The presence of biliary pus on the following ERCP was analyzed. We divided patients into acute suppurative calculous cholangitis (ASCC) (n=26) and acute nonsuppurative calculous cholangitis (ANSCC) groups. Predictive markers for ASCC were analyzed.

    Results Fifty-five patients (41%) presented with no bile juice on EGD. In 21 patients (27.3%) of the bile (-) group and 5 (4.4%) of the bile (+) group (p< 0.01), pus could be seen during ERCP. The absence of bile juice on EGD (odds ratio [OR] for ASCC: 6.170, 95% confidence interval [CI]=1.858-20.495) and total bilirubin (OR for ASCC: 1.232, 95% CI=1.058-1.436) were independent predictive factors for ASCC.

    Conclusions The absence of bile juice on EGD and high total bilirubin level can be predictive markers for ASCC. Performing EGD before ERCP to evaluate the presence of bile juice can be beneficial to predict ASCC and determine the timing of biliary drainage.


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