{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:42:19Z","timestamp":1787071339855,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Introduction:<\/jats:title>\n Acute obstructive suppurative cholangitis (AOSC) is a life-threatening biliary tract infection requiring urgent intervention. With the advancement of endoscopic techniques, endoscopic retrograde cholangiopancreatography (ERCP) has become a preferred alternative to traditional surgery. This study aimed to compare the clinical efficacy and safety of ERCP with laparoscopic common bile duct exploration (LCBDE) in patients with AOSC.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods:<\/jats:title>\n \n This retrospective study included 174 patients diagnosed with AOSC at Shangrao Municipal Hospital between December 2021 and December 2024. Participants were retrospectively assigned to two exposure groups based on treatment received: ERCP group (\n n<\/jats:italic>\n = 70) and LCBDE group (\n n<\/jats:italic>\n = 104). No matching was performed. Clinical outcomes, including intraoperative parameters, post-operative recovery, complications and treatment efficacy within 30 days, were analysed. Logistic regression was used to identify independent predictors of treatment success.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Compared to the laparoscopic group, the ERCP group showed markedly reduced intraoperative blood loss and shorter operation time (\n P<\/jats:italic>\n < 0.001). On post-operative day 7, the ERCP group had lower white blood cell (WBC) counts and serum aspartate aminotransferase levels (\n P<\/jats:italic>\n < 0.05). The overall complication rate (17.14% vs. 35.58%,\n P<\/jats:italic>\n = 0.008) was lower, and the treatment efficacy rate (85.71% vs. 66.35%,\n P<\/jats:italic>\n = 0.004) was higher in the ERCP group. Multivariate analysis identified ERCP, higher pre-operative alanine aminotransferase and lower post-operative WBC as independent predictors of successful treatment.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n ERCP is a safe and effective minimally invasive treatment for AOSC, offering advantages in recovery and complication reduction. It is especially suitable for elderly and high-risk patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jmas.jmas_273_25","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T09:00:09Z","timestamp":1763974809000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy and safety of endoscopic retrograde cholangiopancreatography versus laparoscopic surgery in the management of acute obstructive suppurative cholangitis: A retrospective comparative study"],"prefix":"10.4103","author":[{"given":"Qiang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of General Surgery, Shangrao Municipal Hospital, Shangrao, Jiangxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqiang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shangrao Municipal Hospital, Shangrao, Jiangxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shangrao Municipal Hospital, Shangrao, Jiangxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"R1-20251201","doi-asserted-by":"crossref","first-page":"685","DOI":"10.5694\/j.1326-5377.1984.tb108336.x","article-title":"Acute obstructive suppurative cholangitis","volume":"140","author":"O'Rourke","year":"1984","journal-title":"Med J Aust"},{"key":"R2-20251201","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/0002-9610(76)90003-9","article-title":"The urgency of diagnosis and surgical treatment of acute suppurative cholangitis","volume":"131","author":"Welch","year":"1976","journal-title":"Am J Surg"},{"key":"R3-20251201","first-page":"221","article-title":"Bacteriology and antimicrobial susceptibility in biliary tract disease:An audit of 10-year's experience","volume":"18","author":"Chang","year":"2002","journal-title":"Kaohsiung J Med Sci"},{"key":"R4-20251201","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/S0016-5107(87)71560-0","article-title":"Acute suppurative obstructive cholangitis due to stones:Treatment by urgent endoscopic sphincterotomy","volume":"33","author":"Gogel","year":"1987","journal-title":"Gastrointest Endosc"},{"key":"R5-20251201","doi-asserted-by":"crossref","first-page":"100258","DOI":"10.1016\/j.clinsp.2023.100258","article-title":"Efficacy of ultrasound-guided percutaneous transhepatic biliary drainage for acute obstructive suppurative cholangitis combined with septic shock","volume":"78","author":"Meng","year":"2023","journal-title":"Clinics (Sao Paulo)"},{"key":"R6-20251201","first-page":"316","article-title":"Risk factors for death of elderly patients with acute obstructive suppurative cholangitis","volume":"65","author":"Ma","year":"2015","journal-title":"West Indian Med J"},{"key":"R7-20251201","doi-asserted-by":"crossref","first-page":"2866","DOI":"10.18203\/2349-2902.isj20213637","article-title":"Current status and research progress of endoscopic retrograde cholangiopancreatography in the diagnosis and treatment of biliary and pancreatic system diseases","volume":"8","author":"Yuehu","year":"2021","journal-title":"Int Surg J"},{"key":"R8-20251201","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1001\/jama.2018.14481","article-title":"Endoscopic retrograde cholangiopancreatography","volume":"320","author":"Baiu","year":"2018","journal-title":"JAMA"},{"key":"R9-20251201","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1136\/bmj.39339.610000.BE","article-title":"The declaration of Helsinki","volume":"335","author":"Goodyear","year":"2007","journal-title":"BMJ"},{"key":"R10-20251201","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/jhbp.518","article-title":"Tokyo guidelines 2018: Antimicrobial therapy for acute cholangitis and cholecystitis","volume":"25","author":"Gomi","year":"2018","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"R11-20251201","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4254\/wjh.v4.i2.18","article-title":"Concept of the pathogenesis and treatment of cholelithiasis","volume":"4","author":"Reshetnyak","year":"2012","journal-title":"World J Hepatol"},{"key":"R12-20251201","doi-asserted-by":"crossref","first-page":"128","DOI":"10.3892\/etm.2024.12416","article-title":"ERCP endoscopic minimally invasive treatment of acute suppurative obstructive cholangitis: A study of 47 patients","volume":"27","author":"Lu","year":"2024","journal-title":"Exp Ther Med"},{"key":"R13-20251201","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bjophthalmol-2017-310324","article-title":"Management of postoperative inflammation after cataract and complex ocular surgeries: A systematic review and Delphi survey","volume":"101","author":"Aptel","year":"2017","journal-title":"Br J Ophthalmol"},{"key":"R14-20251201","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1067\/mge.2003.52","article-title":"Biliary sphincterotomy plus dilation with a large balloon for bile duct stones that are difficult to extract","volume":"57","author":"Ersoz","year":"2003","journal-title":"Gastrointest Endosc"},{"key":"R15-20251201","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.3109\/00365521.2012.690046","article-title":"Prospective comparative study of endoscopic papillary large balloon dilation and endoscopic sphincterotomy for removal of large bile duct stones in patients above 45 years of age","volume":"47","author":"Oh","year":"2012","journal-title":"Scand J Gastroenterol"},{"key":"R16-20251201","doi-asserted-by":"crossref","first-page":"w13823","DOI":"10.4414\/smw.2013.13823","article-title":"Comparison of the safety and effectiveness of endoscopic biliary decompression by nasobiliary catheter and plastic stent placement in acute obstructive cholangitis","volume":"143","author":"Zhang","year":"2013","journal-title":"Swiss Med Wkly"},{"key":"R17-20251201","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1111\/1751-2980.12107","article-title":"Endoscopic nasobiliary drainage with sphincterotomy in acute obstructive cholangitis: A prospective randomized controlled trial","volume":"15","author":"Zhang","year":"2014","journal-title":"J Dig Dis"},{"key":"R18-20251201","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1097\/MEG.0b013e328348c0bf","article-title":"Effects of endoscopic papillary balloon dilation and endoscopic sphincterotomy on bacterial contamination of the biliary tract","volume":"23","author":"Natsui","year":"2011","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"R19-20251201","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.gie.2011.01.047","article-title":"Complication of cardiac air embolism during ERCP and EUS-assisted cyst-gastrostomy for pancreatic pseudocyst","volume":"75","author":"Jow","year":"2012","journal-title":"Gastrointest Endosc"},{"key":"R20-20251201","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1038\/ajg.2010.421","article-title":"Large balloon dilation versus mechanical lithotripsy for the management of large bile duct stones: A prospective randomized study","volume":"106","author":"Stefanidis","year":"2011","journal-title":"Am J Gastroenterol"},{"key":"R21-20251201","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s00534-010-0362-5","article-title":"Current status of endoscopic papillary balloon dilation for the treatment of bile duct stones","volume":"18","author":"Aiura","year":"2011","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"R22-20251201","doi-asserted-by":"crossref","first-page":"5386","DOI":"10.3748\/wjg.v23.i29.5386","article-title":"Outcomes of preoperative endoscopic nasobiliary drainage and endoscopic retrograde biliary drainage for malignant distal biliary obstruction prior to pancreaticoduodenectomy","volume":"23","author":"Zhang","year":"2017","journal-title":"World J Gastroenterol"},{"key":"R23-20251201","doi-asserted-by":"crossref","first-page":"4264","DOI":"10.3748\/wjg.v22.i16.4264","article-title":"Urgent endoscopic ultrasound-guided choledochoduodenostomy for acute obstructive suppurative cholangitis-induced sepsis","volume":"22","author":"Minaga","year":"2016","journal-title":"World J Gastroenterol"},{"key":"R24-20251201","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1055\/a-1537-8999","article-title":"Curriculum for ERCP and endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) position statement","volume":"53","author":"Johnson","year":"2021","journal-title":"Endoscopy"},{"key":"R25-20251201","doi-asserted-by":"crossref","first-page":"356","DOI":"10.3390\/gidisord5030029","article-title":"Training in pediatric gastrointestinal endoscopy during surgery residency: Can training programs currently educate proficient pediatric endoscopists? A nationwide assessment","volume":"5","author":"Parente","year":"2023","journal-title":"Gastrointest Disord"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_273_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:44:38Z","timestamp":1787067878000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_273_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":25,"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_273_25","relation":{},"ISSN":["0972-9941","1998-3921"],"issn-type":[{"value":"0972-9941","type":"print"},{"value":"1998-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,24]]},"assertion":[{"value":"2025-07-02","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}