title: Does the addition of endoscopic sphincterotomy to stent insertion improve drainage of the bile duct in acute suppurative cholangitis?
abstract: BACKGROUND
  The treatment of patients with bile duct stones and acute suppurative cholangitis is emergent biliary decompression either by endoscopic sphincterotomy, nasobiliary drainage, or stent insertion. The aim of this retrospective study was to determine whether endoscopic sphincterotomy, in addition to an internal endoprosthesis, improves outcome for patients with acute suppurative cholangitis.
  
  
  METHODS
  A total of 74 patients with acute suppurative cholangitis and bile duct stones were included in the study; 37 had endoscopic sphincterotomy before insertion of plastic stent (Group 1), and 37 had a plastic stent inserted through an intact papilla (Group 2).
  
  
  RESULTS
  The success rates for stent insertion in Groups 1 and 2 were, respectively, 89.2% and 86.5% (p = 1.000). The complication rates in Group 1 and Group 2 were, respectively, 10.8% and 2.7% (p = 0.358). The median (interquartile range 25th-75th percentile) durations of hospital stay for patients in Group 1 and Group 2 were, respectively, 6.5 (4-11) days and 7 (5-12) days (p = 0.614). The median (interquartile range) lengths of time for resolution of jaundice in Group 1 and Group 2 were, respectively, 3 (2-6) days versus 4 (2-5) days (p = 0.981).
  
  
  CONCLUSIONS
  Endoscopic sphincterotomy, in addition to biliary stent insertion, is not required for successful biliary decompression in patients with severe acute cholangitis.
authors.affiliation: Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Chee-Kin
authors.initials: CK
authors.lastname: Hui
authors.forename: Kam-Chuen
authors.initials: KC
authors.lastname: Lai
authors.forename: Man-Fung
authors.initials: MF
authors.lastname: Yuen
authors.forename: Matthew
authors.initials: M
authors.lastname: Ng
authors.forename: Chi-Kuen
authors.initials: CK
authors.lastname: Chan
authors.forename: Wayne
authors.initials: W
authors.lastname: Hu
authors.forename: Wai-Man
authors.initials: WM
authors.lastname: Wong
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Lai
authors.forename: Benjamin C Y
authors.initials: BC
authors.lastname: Wong
mesh_terms: D000208:Acute Disease; D002761:Cholangitis / Q000601:surgery* / Q000628:therapy; D019299:Decompression, Surgical; D004322:Drainage; D006801:Humans; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic; D015607:Stents; D016896:Treatment Outcome