What is the role of endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and management of acute cholangitis?

Updated: Dec 29, 2017
  • Author: Timothy M Scott, DO; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Endoscopic retrograde cholangiopancreatography (ERCP) is both diagnostic and therapeutic and is considered the criterion standard for imaging the biliary system.

ERCP should be reserved for patients who may require therapeutic intervention. Patients with a high clinical suspicion for cholangitis should proceed directly to ERCP.

ERCP has a high success rate (98%) and is considered safer than surgical and percutaneous intervention.

Diagnostic use of ERCP carries a complication rate of approximately 1.38% and a mortality rate of 0.21%. The major complication rate of therapeutic ERCP is 5.4%, and it has a mortality rate of 0.49%. Complications include pancreatitis, bleeding, and perforation. [16]

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