Cholangitis surgery
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]
Overview
Surgery is not recommended for the treatment of cholangitis. Initial management in patients can be conserved through proper antibiotics, as the majority of them can resolve symptoms.
Surgery
Surgical options for cholangitis are not preferred for treatment.[1]
- Only when sepsis progresses does biliary drainage become necessary.
Initial management of all patients includes:[2]
- Intravenous fluid resuscitation and antibiotics
- Invasive monitoring
- Intensive care
- Inotropic and ventilation support
If attempts at an endoscopic papillotomy or percutaneous transhepatic drainage of the common bile duct are unsuccessful, surgical exploration should be carried out to control sepsis.[3] Clinical studies show that emergency surgery for patients suffering from acute cholangitis results in improved postoperative morbidity and mortality rates.[1]
References
- ↑ 1.0 1.1 Lai EC, Tam PC, Paterson IA, Ng MM, Fan ST, Choi TK, Wong J (1990). “Emergency surgery for severe acute cholangitis. Postoperative risk factors are high in surgery. The high-risk patients”. Ann. Surg. 211 (1): 55–9. PMC 1357893. PMID 2294844.
- ↑ Liu, CL & Fan, ST (2001), Surgical Treatment: Evidence-Based and Problem-Oriented (24 ed.), Munich, Germany: Zuckschwerdt
- ↑ Himal HS, Lindsay T (1990). “Ascending cholangitis: surgery versus endoscopic or percutaneous drainage”. Surgery. 108 (4): 629–33, discussion 633–4. PMID 2218872.
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