Zhang X, Li G, Pan L, et al. - Researchers examined the efficacy and safety of one-stage endoscopic retrograde cholangiopancreatography (ERCP) for ascending acute cholangitis concerning in patients with severe comorbidities by performing a retrospective study. They assessed 212 patients with ascending acute cholangitis who were undergoing ERCP between January 2017 and March 2019: 74 and 138 with and without severe comorbidities. Patients with severe comorbidities were elderly (76.20 ± 9.99 years vs 66.52 ± 8.16 years), had higher levels of leukocyte count (15.86 ± 2.47 × 10⁹/ml vs 13.49 ± 1.65 × 10⁹/ml), and serum bilirubin (3.11 ± 1.29 mg/dl vs 1.94 ± 0.90 mg/dl). A significantly higher proportion of these patients were severe cases (32.4% vs 6.5%), American Society of Anesthesiologists (ASA) stage V status (37.8% vs 10.1%) and had undergone general anesthesia (56.8% vs 18.8%). In 207 and 202 patients, one session led to successful biliary cannulation and complete stone clearance, respectively. The mean length of hospital stay of 8.02 ± 2.71 days was reported. Outcomes support the safety and efficacy of one-stage ERCP for ascending acute cholangitis caused by choledocholithiasis. For clinical outcomes, the early diagnosis was identified as a significant predictor.