The Comparisons of One-stage Stone Removal in Mild and Moderate Cholangitis

Investigators will enroll 204 naïve papilla with a body temperature ≥37 °C who was diagnosed with mild to moderate cholangitis associated with choledocholithiasis. The method of one-stage: performing the stone removal at the first session of ERCP. The pancreas duct stent will be placed for preventing post ERCP pancreatitis (PEP) if necessary. The indomethacin 100mg anal route will be administered for all patients without allergy history. All participants will receive the empiric antibiotics treatment for cholangitis.

Inclusion criteria

• naïve papilla with a body temperature ≥37 °C who was diagnosed with mild to moderate cholangitis associated with choledocholithiasis.

Exclusion criteria

• procedural failure requiring an anatomy-modifying procedure, such as a Billroth II subtotal gastrectomy or R-en-Y gastrojejunostomy ;
• stenosis of the pyloric ring ;
• tumor-related obstruction;
• failure to locate the papilla ;
• active peptic ulcer bleeding ;
• intolerance due to inadequate sedation
• CBD sludge;
• non-naïve papilla in ERCP