{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:03:11Z","timestamp":1791838991165,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T00:00:00Z","timestamp":1671494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The 2018 Tokyo Guidelines (TG18) recommend urgent endoscopic biliary drainage based on acute cholangitis (AC) severity. Therefore, we evaluated the safety and mortality benefits of urgent endoscopic retrograde cholangiopancreatography (ERCP) in different age groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using International Classification of Diseases\u201010 (ICD\u201010) codes, we sampled adult AC patients from National Inpatient Sample. TG18 definition of cholangitis severity was used to identify patients with severe and nonsevere (mild or moderate) AC. Age categories were 18\u201364, 65\u201379, and 80 and above. Multivariate linear or logistic regression was used as appropriate. We used Stata, version 14.2, to perform analyses considering two\u2010sided <jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.05 as statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 137\u2009100 patients, there were 93\u2009365 (68.09%) patients with nonsevere cholangitis and 43\u2009735 (31.91%) patients with severe cholangitis. Urgent ERCP (within 24\u2009h) resulted in decreased mortality in all age groups for both severe and nonsevere AC. Post\u2010sphincterotomy bleeding was more common in patients \u226580\u2009years of age, whereas post\u2010ERCP acute cholecystitis was more common in patients 65\u201379\u2009years. The rates of post\u2010ERCP pancreatitis, bile duct perforation, and duodenal perforation did not differ among the age groups. In addition, there were no differences in the rate of sedation\u2010related complications between different age groups who underwent urgent ERCP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates the mortality benefit from urgent ERCP for AC in different age groups and describes the safety of performing urgent ERCP in patients of various ages. Therefore, we recommend that urgent ERCP be performed according to the TG18 guidelines regardless of age.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.1275","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T14:58:49Z","timestamp":1668783529000},"page":"737-744","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Validation of Tokyo guidelines 2018 for safety and mortality benefit from urgent <scp>ERCP<\/scp> in acute cholangitis across different age groups"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8272-0172","authenticated-orcid":false,"given":"Umer","family":"Farooq","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Loyola Medicine, MacNeal Hospital  Berwyn Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amlish B.","family":"Gondal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Guthrie Robert Packer Hospital  Sayre Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Franco","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Loyola Medicine, MacNeal Hospital  Berwyn Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahid Ijaz","family":"Tarar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Missouri  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sultan","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology &amp; Nutrition University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010198904000\u201000008"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534\u2010012\u20100564\u20100"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.512"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199001000\u201000009"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.086371"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2017.04.009"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.458"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534\u2010012\u20100561\u20103"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.509"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100034\u20101365281"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2000.107285"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl13310"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102036.2004.01962.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.14744\/less.2020.26429"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1499\u20103872(16)60130\u20103"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i37.8382"},{"key":"e_1_2_8_18_1","volume-title":"Overview of the National (Nationwide) Inpatient Sample (NIS)","author":"Project HCaU","year":"2022"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001627"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876\u2010018\u20100854\u20103"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.06.051"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i9.1372"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.04.032"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650\u2010200208001\u201000004"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2013.0478"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895\u20104356(92)90133\u20108"}],"container-title":["Journal of Hepato-Biliary-Pancreatic Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhbp.1275","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jhbp.1275","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhbp.1275","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T13:56:01Z","timestamp":1692453361000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jhbp.1275"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,20]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1002\/jhbp.1275"],"URL":"https:\/\/doi.org\/10.1002\/jhbp.1275","archive":["Portico"],"relation":{},"ISSN":["1868-6974","1868-6982"],"issn-type":[{"value":"1868-6974","type":"print"},{"value":"1868-6982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,20]]},"assertion":[{"value":"2022-06-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}