Cholangitis surgery: Difference between revisions
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{{Cholangitis}} | {{Cholangitis}} | ||
{{CMG}} {{AE}} {{FH}} | {{CMG}}; {{AE}} {{FH}} | ||
==Overview== | ==Overview== | ||
Surgery is not the | [[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== | ==Surgery== | ||
Surgical options for cholangitis are not preferred for treatment.<ref name="pmid2294844">{{cite journal |vauthors=Lai EC, Tam PC, Paterson IA, Ng MM, Fan ST, Choi TK, Wong J |title=Emergency surgery for severe acute cholangitis. Postoperative risk factors are high in surgery. The high-risk patients |journal=Ann. Surg. |volume=211 |issue=1 |pages=55–9 |year=1990 |pmid=2294844 |pmc=1357893 |doi= |url=}}</ref> | |||
*Only when [[sepsis]] progresses does biliary drainage become necessary. | |||
Initial management of all patients includes:<ref name="book123">{{Citation | |||
| last1 = Liu | | last1 = Liu | ||
| first1 = CL | | first1 = CL | ||
| Line 21: | Line 21: | ||
| year = 2001 | | year = 2001 | ||
}}</ref> | }}</ref> | ||
*[[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]] | 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]].<ref name="pmid2218872">{{cite journal |vauthors=Himal HS, Lindsay T |title=Ascending cholangitis: surgery versus endoscopic or percutaneous drainage |journal=Surgery |volume=108 |issue=4 |pages=629–33; discussion 633–4 |year=1990 |pmid=2218872 |doi= |url=}}</ref> Clinical studies show that emergency surgery for patients suffering from acute cholangitis results in improved postoperative [[morbidity]] and [[mortality]] rates.<ref name="pmid2294844">{{cite journal |vauthors=Lai EC, Tam PC, Paterson IA, Ng MM, Fan ST, Choi TK, Wong J |title=Emergency surgery for severe acute cholangitis. The high-risk patients |journal=Ann. Surg. |volume=211 |issue=1 |pages=55–9 |year=1990 |pmid=2294844 |pmc=1357893 |doi= |url=}}</ref> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
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[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Surgery]] | |||
Latest revision as of 20:55, 29 July 2020
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Cholangitis surgery On the Web |
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American Roentgen Ray Society Images of 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.