Abstract: Objective The aim of this study was to compare the efficacy of endoscopic retrograde cholangiopancreatography (ERCP) and open surgery in the treatment of patients with acute obstructive suppurative cholangitis (AOSC). Methods A total of 103 patients with AOSC were encountered in our hospital between January 2020 and January 2023, and 58 patients in observation group received ERCP therapy and 45 patients in control group received open laparotomy. The pain was evaluated by visual analogue scale (VAS), and serum interleukin(IL)-6, IL-1, tumor necrosis factor (TNF)-α and C-reactive protein (CRP) levels were detected by ELISA. Results The intraoperative blood loss, operation time, VAS score at day three after surgery and hospitalization stay in the observation group were(30.7±4.6)mL, (74.3±8.8)min, (3.1±0.8) and (7.2±1.4)d, all significantly less or shorter than in the control; at day five after surgery, serum ALT and GGT levels in the observation group were (48.2±4.1)U/L and (163.9±17.2)U/L, both significantly lower than in the control; serum IL-6, IL-1, TNF-α and CRP levels in the observation were (82.6±8.3)ng/L, (20.9±4.0)ng/L, (16.2±3.5)ng/L and (18.1±2.2)mg/L, all significantly lower than in the control; the incidence of post-operational complications in the observation group was significantly lower than that in the control group (5.1% vs. 17.8%, P<0.05). Conclusion The ERCP therapy was successfully completed in our series, and it could deal emergently or urgently with patients with AOSC, which warrants further clinical investigation.

Key words: Acute obstructive suppurative cholangitis, Endoscopic retrograde cholangiopancreatography, Cytokines, Therapy