scholarly journals Performance of diagnostic tools for acute cholangitis in patients with suspected biliary obstruction

2021 ◽  
Author(s):  
Christina J. Sperna Weiland ◽  
Celine B.E. Busch ◽  
Abha Bhalla ◽  
Marco J. Bruno ◽  
Paul Fockens ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Acute Cholangitis ◽  
Diagnostic Tools

scholarly journals Optimal timing of endoscopic retrograde cholangiopancreatography for acute cholangitis associated with distal malignant biliary obstruction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Namyoung Park ◽  
Sang Hyub Lee ◽  
Min Su You ◽  
Joo Seong Kim ◽  
Gunn Huh ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Biliary Obstruction ◽  
Acute Cholangitis ◽  
Mortality Rates ◽  
Malignant Biliary Obstruction ◽  
Optimal Timing ◽  
Endoscopic Retrograde ◽  
The Difference ◽  
Distal Malignant Biliary Obstruction

Abstract Background There is a lack of studies regarding the optimal timing for endoscopic retrograde cholangiopancreatography (ERCP) in patients with cholangitis caused by distal malignant biliary obstruction (MBO). This study aims to investigate the optimal timing of ERCP in patients with acute cholangitis associated with distal MBO with a naïve papilla. Methods A total of 421 patients with acute cholangitis, associated with distal MBO, were enrolled for this study. An urgent ERCP was defined as being an ERCP performed within 24 h following emergency room (ER) arrival, and early ERCP was defined as an ERCP performed between 24 and 48 h following ER arrival. We evaluated both 30-day and 180-day mortality as primary outcomes, according to the timing of the ERCP. Results The urgent ERCP group showed the lowest 30-day mortality rate (2.2%), as compared to the early and delayed ERCP groups (4.3% and 13.5%) (P < 0.001). The 180-day mortality rate was lowest in the urgent ERCP group, followed by early ERCP and delayed ERCP groups (39.4%, 44.8%, 60.8%; P = 0.006). A subgroup analysis showed that in both the primary distal MBO group, as well as in the moderate-to-severe cholangitis group, the urgent ERCP had significantly improved in both 30-day and 180-day mortality rates. However, in the secondary MBO and mild cholangitis groups, the difference in mortality rate between urgent, early, and delayed ERCP groups was not significant. Conclusions In patients with acute cholangitis associated with distal MBO, urgent ERCP might be helpful in improving the prognosis, especially in patients with primary distal MBO or moderate-to-severe cholangitis.

scholarly journals Laproscopic Management of Wandering Biliary Ascariasis

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Umesh Jethwani ◽  
G. J. Singh ◽  
P. Sarangi ◽  
Vipul Kandwal
Keyword(s):  
Public Health ◽  
Biliary Obstruction ◽  
Rare Case ◽  
Acute Cholangitis ◽  
Young Male ◽  
Conventional Management ◽  
Biliary Ascariasis ◽  
Endoscopic Extraction ◽  
Extrahepatic Biliary Obstruction ◽  
The Common

Ascariasis is one of the most common helminthic diseases in humans, occurring mostly in countries with low standards of public health and hygiene, thereby making ascariasis highly endemic in developing countries. In endemic areas, 30% of adults and 60–70% of children harbour the adult worm. Biliary ascariasis is a rare cause of obstructive jaundice. Conventional management involves endoscopic extraction of worm. We are reporting a rare case of ascaris which induced extrahepatic biliary obstruction in a young male who presented with acute cholangitis. The ascaris was removed by laparoscopic exploration of the common bile duct. Postoperative period was uneventful.

scholarly journals The Clinical and Pathologic Correlations in Mechanical Biliary Obstruction and Acute Cholangitis

1982 ◽  
Vol 195 (4) ◽  
pp. 419-423 ◽  
Author(s):  
MELODY J. OʼCONNOR ◽  
HATTON W. SUMNER ◽  
MICHAEL L. SCHWARTZ
Keyword(s):  
Biliary Obstruction ◽  
Acute Cholangitis

scholarly journals DIAGNOSTICCRITERIAANDMANAGMENTOF ACUTE CHOLANGITIS AND BILIARY SEPSIS: THE MODERN VIEW ON THE PROBLEM

2019 ◽  
Vol 21 (1) ◽  
pp. 40-43
Author(s):  
A Yu Korolkov ◽  
D N Popov ◽  
M A Kitaeva ◽  
A O Tantsev
Keyword(s):  
Hospital Stay ◽  
Diagnostic Criteria ◽  
Economic Efficiency ◽  
Biliary Obstruction ◽  
Acute Cholangitis ◽  
Treatment Results ◽  
Inflammation Response ◽  
Improve Treatment ◽  
Duration Of Hospital Stay ◽  
Biliary Sepsis

Theproblemofcholangitisandbiliarysepsisbecomemoreandmoreactual.Developingdiagnosticcriteriaforpatientswithinflammationofbiliarytractisoneofunsolvedquestionsofbiliarysurgery. Accordingtonewclassificationofgeneralizedformofinfections (Sepsis 3) it’sadvisabletoclassifiedpatients with biliary obstruction to three groups: mechanical jaundice, acute cholangitis and biliary sepsis with defying appropriate diagnostic criteria for each of them.Theaimofourworkistoimprovetreatmentresultsforpatientswithhyperbilirubinemia, biliary hypertension and system inflammation response syndrome (SIRS) by dividing them on groups and determining diagnostic criteria for each of them. Intheperiodfrom 2014 to 2018 wehavetreated 208 patientswithbiliaryobstruction. Accordingtodevelopeddiagnosticcriteriaallpatients was divided on three groups: mechanical jaundice, acute cholangitis and biliary sepsis.Afterthetreatmentthenextvalueswereanalyzed: timefromadmissiontohospitaltooperation, thetimeofoperation, thefrequencyofpostoperativecomplications, mortality, the duration of hospital stay, economic efficiency.Toassesstheeffectivesofdevelopedcriteriacomparativeanalysiswithretrospectivegroup, whichcontained 182 patients with hyperbilirubinemia, biliary hypertension and SIRS treated in a period from 2010 to 2014, was performed. Accordingtoobtainedresultswecanconcludethatdividingpatientswithhyperbilirubinemia, biliary hypertension and SIRS on groups and developeddiagnosticcriteria, routing and manage tactics let us to improve treatment results in this category of patients, about what we can judge by such figures as timefromadmissiontohospitaltooperation, thefrequencyofpostoperativecomplications, mortality, the duration of hospital stay, economic efficiency.

scholarly journals Mirizzy syndrome complicated by acute cholangitis in pregnant

2020 ◽  
Vol 25 (1) ◽  
pp. 124-128
Author(s):  
A. V. Osipov ◽  
A. E. Demko ◽  
D. A. Surov ◽  
I. A. Soloviev ◽  
A. V. Sviatnenko ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Surgical Procedure ◽  
Biliary Obstruction ◽  
Acute Cholangitis ◽  
The Common

A case report of the patient at week 21 of pregnancy with Mirizzi type 2 syndrome complicated by acute cholangitis is described. During the examination, the level and cause of the biliary obstruction (cholecystocholedocheal fistula and gallstone of the common bile duct) were revealed. A detailed description of the surgical procedure is presented: subtotal laparoscopic cholecystectomy, choledochotomy, choledochoscopy, lithoextraction, drainage of the common bile duct. The analysis of information from literature sources is carried out.

scholarly journals Validity and safety of endoscopic biliary stenting for biliary stricture associated with IgG4-related pancreatobiliary disease during steroid therapy

2019 ◽  
Vol 07 (11) ◽  
pp. E1410-E1418 ◽  
Author(s):  
Yasuhiro Kuraishi ◽  
Takashi Muraki ◽  
Norihiro Ashihara ◽  
Makiko Ozawa ◽  
Akira Nakamura ◽  
...  
Keyword(s):  
Steroid Therapy ◽  
Liver Dysfunction ◽  
Biliary Obstruction ◽  
Biliary Stricture ◽  
Acute Cholangitis ◽  
Rank Test ◽  
Biliary Stenting ◽  
Steroid Administration ◽  
Endoscopic Biliary Stenting ◽  
Log Rank Test

Abstract Background Patients with IgG4-related sclerosing cholangitis and autoimmune pancreatitis frequently develop obstructive jaundice, which requires endoscopic biliary stenting (EBS) during steroid therapy to prevent bile duct infection from cholestasis and adverse steroid effects. However, it is controversial whether EBS during steroid therapy is advisable, because the procedure itself carries a risk of cholangitis and procedure-related adverse events. This study aimed to clarify the validity and safety of EBS for patients with biliary stricture associated with IgG4-related pancreatobiliary disease (IgG4-PBD) during steroid therapy. Methods We enrolled 59 patients who presented with biliary stricture exhibiting jaundice or liver dysfunction and who were treated with EBS. The incidences of recurrent biliary obstruction and acute cholangitis were compared for EBS cases with and without steroid administration. Results EBS was present in 55 periods with steroid administration and 110 periods without. The incidence of recurrent biliary obstruction was significantly lower in cases with steroids than in those without (1-month no obstruction rate: 100 % vs. 82 %; log-rank test P = 0.0015). The incidence of acute cholangitis related to stenting was significantly lower in cases with steroids than in those without (1-month no acute cholangitis rate: 100 % vs. 90 %; log-rank test P = 0.0278). Biliary stents could be removed without acute cholangitis, liver dysfunction, or stent replacement in 96 % of patients who underwent endoscopic retrograde cholangiopancreatography 1 month after commencing steroid administration. Conclusions EBS during steroid administration was both valid and safe in patients with biliary stricture associated with IgG4-PBD. Stents could be safely removed 1 month after steroid initiation.

scholarly journals Acute Cholangitis without Biliary Obstruction: Causes and Radiologic Features

2010 ◽  
Vol 62 (6) ◽  
pp. 533
Author(s):  
Jung Hyun Jo ◽  
Hee Jin Kwon ◽  
Myongjin Kang ◽  
Seong Kuk Yoon ◽  
Jin Han Cho
Keyword(s):  
Biliary Obstruction ◽  
Acute Cholangitis ◽  
Radiologic Features

scholarly journals An Unusual Cause of Biliary Obstruction

2012 ◽  
Vol 5 ◽  
pp. CCRep.S9875
Author(s):  
Sern Wei Yeoh
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Current Literature ◽  
Biliary Obstruction ◽  
Acute Cholangitis ◽  
Chronic Liver ◽  
Pancreatic Ducts ◽  
Portal Venous System ◽  
Diagnosis And Management

Portal biliary ductopathy (PBD) is a condition in which biliary and pancreatic ducts are extrinsically compressed by collateral branches of the portal venous system, which in turn have become dilated and varicosed due to portal hypertension. While the majority of patients with PBD are asymptomatic, a minority can present with symptoms of biliary obstruction and cholangitis with the potential of developing secondary chronic liver disease. This paper reports the case of a 29 year old male presenting with acute cholangitis, in whom PBD was diagnosed radiologically. A brief review of current literature regarding the diagnosis and management of this condition will also be presented.

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