Abstract
On each line: pCLE image representative of a query video (framed image on the left), followed by 3 pCLE images representative of the 3 atlas videos which have been automatically recognized by the Smart Atlas software as the most visually similar to the query video. Each pCLE video is annotated with final diagnosis. Su1663 An Open-Labeled, Randomized Controlled Trial Comparing Between Short Duration and Standard 14 Days Antibiotic Treatments for Acute Cholangitis in Patients With Common Bile Duct Stone After Successful Endoscopic Biliary Drainage. a Preliminary Report Duangswang Limmathurotsakul*, Nisa Netinatsunton, Siriboon Attasaranya, Bancha Ovartlarnporn Medicine, Faculty of Medicine, Prince of Songkla university, Division of gastroenterology, Hatyai, Thailand; NKC institute of Gastroenterology and Hepatology, Hatyai, Thailand Background: Acute cholangitis is generally treated with endoscopic biliary drainage (EBD) and systemic antibiotics. The traditional duration of antibiotic treatment varied from 7-14 days after endoscopic biliary drainage. Data regarding short duration of antibiotic treatment after EBD are limited. Aims. To compare the efficacy and safety of short duration with standard fourteen days antibiotic treatment in patients with acute cholangitis due to common bile duct stone (CBDS) after successful endoscopic biliary drainage. Methods: A prospective randomized study of patients with mild to moderate acute cholangitis due to CBDS with symptoms duration! 48 hours were randomized at the time of ERCP to a short duration (group A) or standard fourteen days antibiotic treatment (group B) from February 2013 to November 2013. Ceftriaxone was used for antibiotic therapy. The endoscopic drainage by ERCP was done within 72 hours after admission. Endoscopic drainage was defined as complete when all the CBDSs were removed and as incomplete when some residual stones were present with stent insertion done. In the short duration treatment group, antibiotic was stopped when the patient was afebrile for 72 hours. The study protocol was approved by local Ethics Committee. Results: 14 patients with 6 female and 8 male and the mean age 70.2+16.2 years were recruited. 7 were in group A and 7 in group B. The demographic data, the abdominal pain intensity, LFT and number of CBDS were not significantly different between the 2 groups. The clinical response including duration of fever, abdominal pain, improvement of LFT, and the number of patient with incomplete drainage after treatment were similar between group A and B. The mean duration + SD of antibiotic treatment in group A was 5 +1.8 days with a range of 4-9 days. There were 3 patients with bacteremia in each group but none of patients in both groups developed recurrent cholangitis after 2 months of follow-up. Conclusions: Our preliminary data suggested that short duration antibiotic therapy for acute CBDS cholangitis after successful endoscopic biliary drainage was safe and effective as the standard fourteen days antibiotic treatment. Baseline characteristic data AB358 GASTROINTESTINAL E Group A (Treatment) NDOSCOPY Vo Group B (Control) lume 79, No. P Value Total patient 7 7 Sex (male/female), n 4/3 5/2 Age (y), mean (SD) 72.9(17.2) 67.6(16.2) 0.564 Abdominal pain score before ERCP (0-10), mean (SD) 9.29(1.89) 8.71(1.60) 0.554 5S : 2014 Group A (Treatment) Group B (Control)
Published Version
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