ERCP
Clinical teaching and practical ideas for your next study session.
Case Discussion
Acute Cholangitis on Warfarin: Separate Drainage From Sphincterotomy
With obstructed cholangitis and an INR of 3.2, the key procedural question is whether urgent duct decompression can be separated from sphincterotomy and stone extraction. Stent-only ERCP may be appropriate when the patient’s condition, anticoagulation, and technical feasibility favor staging—but the INR and procedure plan both need context.