Epidemiology and Prognostic Determinants of Patients with Bacteremic Cholecystitis or Cholangitis

Lee, Chien‐Chang; Chang, I‐Jing; Lai, Yi-Chun; Chen, Shey-Ying

doi:10.1111/j.1572-0241.2007.01095.x

Cited by 91 publications

(81 citation statements)

References 25 publications

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“…In the present study, CRP levels were significantly higher in CBDdil(-) patients than in CBDdil(+) patients. Previous studies have demonstrated that increased levels of CRP, WBCs and T-Bil are associated with severe acute cholangitis and poor patient prognosis (22,23). In the current study, WBC count and T-Bil levels did not differ significantly between the CBDdil(-) and CBDdil(+) groups, suggesting that the severity of acute cholangitis was similar between the groups.…”

Section: Discussionsupporting

confidence: 53%

Comparison of acute cholangitis with or without common bile duct dilatation

Tomizawa

Shinozaki

Hasegawa

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. To improve the management of patients with acute cholangitis, the present study compared laboratory test variables between acute cholangitis patients with or without common bile duct (CBD) dilatation [CBDdil(+) and CBDdil(-), respectively]. The medical records of patients diagnosed with acute cholangitis and subjected to endoscopic retrograde cholangiopancreatography between February 2008 and May 2015 were retrospectively analyzed. The present study consisted of 40 men (aged 69.4±8.8 years) and 37 women (aged 68.8±11.6 years). It was observed that CBDdil(-) patients were slightly younger than CBDdil(+) patients (P=0.0976), and levels of C-reactive protein (CRP) were significantly higher in CBDdil(-) patients than in CBDdil(+) patients (P=0.0392). In addition, logistic regression analysis indicated that CRP levels were associated with the presence of CBD dilatation (P=0.0392). These data indicate that patients with acute cholangitis without CBD dilatation tend to be younger and have higher levels of CRP. Thus, in acute cholangitis patients without CBD dilatation, diagnosis should be determined using clinical symptoms and laboratory data.

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Section: Discussionsupporting

confidence: 53%

Comparison of acute cholangitis with or without common bile duct dilatation

Tomizawa

Shinozaki

Hasegawa

et al. 2017

Experimental and Therapeutic Medicine

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“…A pesar de que inicialmente parece obvio que los pacientes con cáncer tendrán una sobrevida más corta, ello podría no ocurrir cuando el grupo comparador tiene, en promedio, una edad dos décadas superior como en este caso. Otro aspecto relevante es que la patología neoplásica maligna resultó ser una causa frecuente en el desarrollo de colangitis bacteriémica llegando a explicar un tercio de los casos de esta serie, un hallazgo importante por la baja sobrevida ya comentada y por su estrecha asociación con un fracaso en el tratamiento de colangitis, con o sin bacteriemia 2,3 . Otras publicaciones describen hasta 50% de fracaso del tratamiento de la bacteriemia en los casos asociados a neoplasia maligna.…”

Section: Discussionunclassified

Colangitis bacteriémica en adultos en un hospital general en Chile

Fíca

Julio

Palma

et al. 2013

Rev. chil. infectol.

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Background: Some aspects of bacteremic cholangitis are unknown in Chile. Aim: To gather more information on clinical, microbiological aspects as well as risk factors for ICU admission, recurrence and antimicrobial resistance. Material and Methods: A retrospective research was performed using medical records of adult patients in a general hospital. Results: Between 2006Between -2012 patients with 29 bacteremic events were identified. Previous cholangitis events were reported by 27.3%, 45.5% had recent admissions and, 50% had used antimicrobial compounds. Coledocholithiasis was the most common cause of obstruction (45.5%) followed by cancer (36.4%). One third developed shock (31%), the only factor associated with ICU admission (OR 30, p < 0.05). In 24 of the 29 bacteremic events, the biliary tract was intervened (82.8%) and in 80.8% during the first 72 hours. Gram negative bacilli were predominant (> 80%) and some infrequent agents such as Staphylococcus warneri, Shewanella spp. and, Aeromonas spp. were observed. Among enteric gram negative bacilli, 29.2% presented fluoroquinolone resistance and, 26.1% resistance to third generation cephalosporins, both associated with previous endoscopic retrograde cholangiography (OR 35 and 16.5, respectively p < 0.05). A favorable response was observed in 93.1% of bacteremic events but in 31.8% of patients cholangitis recurred with or without bacteremia. Recurrence was associated to recent admission (OR 16.5, p = 0.01) and in all cases occurred before 81 days. In-hospital mortality was 9.1% (n = 2), but in only one case associated to sepsis. Average length of stay (LOS) was 17.8 days. Conclusions: Early intervention of the biliary tract allows a favorable response in patients affected by bacteremic cholangitis, but this condition use intensive care resources, had a prolonged LOS, a recurrent pattern, and is associated with several bacterial species, some of them resistant.

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“…Akut kolesistit, safra kesesinin başlangıçta inflamatuar bir hastalığı-dır ve büyük oranda safra taşlarına bağlı olarak gelişir (13,21) . Safra taşı prevalansı ülkeler arasında farklılıklar göstermektedir.…”

Section: Discussionunclassified

“…Çoğu asemptomatik olmakla beraber olguların ortalama % 20'sinde infeksiyon komplikasyonları gelişebil-mektedir. İlerlemiş tedavilere rağmen bakteriyel biliyer sistem infeksiyonlarında mortalite (% 10-20) önemini korumaktadır (13) . Uzun yıllardır, bakteriler tarafından salgı-lanan beta-glukronidazın, biluribin glukronidi serbest biluribin ve glukronik aside parçalayan enzimatik hidrolizindeki kritik faktör olduğu düşünülmektedir.…”

Section: Discussionunclassified