Ascending cholangitis: surgery versus endoscopic or percutaneous drainage.

摘要: A retrospective review of 61 patients with calculous cholangitis was carried out. There were 31 men and 30 women their mean age 75.8 years. All had abdominal pain, 87% chills fever, 65% clinical jaundice, 23% in shock, 54% positive blood cultures. Because intravenous hydration antibiotics did not help, 33 underwent surgery, 25 endoscopic papillotomy (EP), three percutaneous transhepatic drainage the common bile duct (PTD). Morbidity surgery group included two wound infections, one respiratory failure, renal failure. EP-PTD case arterial bleeding requiring pancreatitis treated conservatively. Two (6%) died group, sepsis other cardiorespiratory arrest. In nine (32%) multisystem organ These considered too ill to undergo thus repeat Cholangitis persisted, retained stones cause death. Thus when initial EP or PTD is unsuccessful, surgical exploration should be out control sepsis.