Timing of Endoscopic Biliary Drainage for Acute Cholangitis Associated with Common Bile Duct Stones in Elderly Patients: A Single-Center Retrospective Cohort Study

Background/Objectives: The optimal timing for biliary drainage in elderly patients remains controversial. This study compared the clinical outcomes of early versus late biliary drainage in elderly patients diagnosed with acute cholangitis associated with common bile duct stones (CBDS). Methods: This single-center, retrospective cohort study compared early (within 24 h of admission) versus late (>24 h after admission) biliary drainage using endoscopic retrograde cholangiopancreatography (ERCP) in 143 elderly patients diagnosed with acute cholangitis, who were divided into early and late groups, respectively. Results: There were no statistical differences in patient characteristics between the early and late drainage groups. Although the time to clinical success was significantly shorter in the early drainage group, there were no significant differences in persistent organ failure, length of hospital stay, in-hospital and 30-day mortality, and ERCP-related adverse events (AEs) between the early and late groups. In the late group, the clinically worsened group tended to exhibit higher white blood cell counts and lower platelet counts on admission. Conclusions: Time to clinical success was significantly shorter in the early drainage group than in the late group. No statistically significant differences in persistent organ failure, length of hospital stay, in-hospital and 30-day mortality, and ERCP-related adverse AEs were detected between early and late biliary drainage in elderly patients with acute cholangitis associated with CBDS.