Efficacy of ultrasound-guided percutaneous transhepatic biliary drainage for acute obstructive suppurative cholangitis combined with septic shock

Meng, Miaomiao; Han, Feng; Tang, Shuan; Peng, Xiaobin

doi:10.1016/j.clinsp.2023.100258

Cited by 2 publications

(2 citation statements)

References 20 publications

(19 reference statements)

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“…The clinical presentation of AOSC commonly includes abdominal pain, fever, jaundice and in severe cases it may be accompanied by septic shock characterized by shock and symptoms of nervous system suppression. AOSC can lead to multiple organ failure if not promptly detected and treated, resulting in a morbidity and mortality rate ranging from 13-88% ( 2 ). There are numerous factors associated with biliary tract infections, including bacterial infections, gallstones and trauma.…”

Section: Introductionmentioning

confidence: 99%

“…Especially in Europe and the United States, with the development of endoscopic technology, the safety and effectiveness of ERCP have been widely studied and established in the treatment of biliary tract diseases ( 4 , 5 ). However, current clinical studies on ERCP in China mainly focus on patients with AC and there is still no conclusion on the efficacy and safety of ERCP in the treatment of AOSC patients, especially elderly patients ( 2 , 6 ). The present study therefore investigated an effective minimally invasive treatment approach that holds promise for improving treatment outcomes for patients with AOSC, with the goals of alleviating suffering and reducing complications, thereby offering a beneficial therapeutic option for both physicians and patients.…”

Section: Introductionmentioning

confidence: 99%

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ERCP endoscopic minimally invasive treatment of acute suppurative obstructive cholangitis: A study of 47 patients

Lu,

Fan

2024

Exp Ther Med

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The primary objective of the present study was to investigate the efficacy and safety of endoscopic therapy for acute obstructive suppurative cholangitis (AOSC) in patients with different underlying conditions. The present study comprised 47 patients diagnosed with AOSC, with a mean age of 70±14 years. Minimally invasive endoscopic treatments, including endoscopic duodenal papillary sphincterotomy, endoscopic duodenal nasobiliary drainage and/or placement of an endobiliary duct stent drainage tube, were performed. Variations in the levels of the white blood cell count, liver function, procalcitonin (PCT) and carbohydrate antigen-199 (CA199) were examined, compared and evaluated both prior to and following endoscopic retrograde cholangiopancreatography (ERCP). Among the 47 patients, 45 had a high fever, although their body temperature returned to normal after 7 days of ERCP treatment. The infection was difficult to control completely in two cases, including one case of biliary anastomosis secondary tumor with stenosis and AOSC and another case of an elderly patient with multiple choledocholithiasis complicated with sepsis. Within 7 days following treatment, the abdominal pain was resolved in 27 patients and jaundice subsided in 29 patients. On the 7th day after endoscopic treatment, the blood leukocyte, liver function, PCT and CA-199 parameters of all patients were significantly improved compared with those at admission. A total of 35 bile cultures yielded positive results, with Escherichia coli accounting for 11 cases (31.4%), Klebsiella pneumoniae accounting for 7 cases (20%), Pseudomonas aeruginosa accounting for 5 cases (14.3%), Enterococcus faecus accounting for 4 cases (11.4%) and other strains making up the remaining 17 cases. No serious complications were encountered with these patients, such as perforation, bleeding, severe pancreatitis or mortality, following ERCP. In conclusion, ERCP has been shown to be a safe and effective minimally invasive treatment method for elderly patients with AOSC, yielding a high rate of success.

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Section: Introductionmentioning

confidence: 99%