Most patients experience rapid clinical improvement once adequate biliary drainage is achieved, with improvement in hemodynamic parameters and systemic inflammatory response parameters. For patients with significant underlying medical conditions and those in whom decompression is delayed, prognosis is poorer. Predictive factors for poor prognosis include hyperbilirubinemia, high fever, leukocytosis, older age, renal dysfunction, coagulopathy, and hypoalbuminemia.[1]Kiriyama S, Kozaka K, Takada T, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos). J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):17-30.
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Patients requiring emergent surgery have higher rates of morbidity and mortality than those managed acutely with nonoperative procedures.