Cholangitis surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
*Surgical options for cholangitis are not preferred for treatment options.<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> | *Surgical options for cholangitis are not preferred for treatment options.<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 | **Only when [[sepsis]] progresses does biliary drainage become necessary. | ||
*Initial management of all patients includes:<ref name="book123">{{Citation | *Initial management of all patients includes:<ref name="book123">{{Citation | ||
| last1 = Liu | | last1 = Liu | ||
| Line 21: | Line 21: | ||
| year = 2001 | | year = 2001 | ||
}}</ref> | }}</ref> | ||
**[[Intravenous fluid]] resuscitation and antibiotics | **[[Intravenous fluid]] resuscitation and antibiotics | ||
** | **Invasive monitoring | ||
**Intensive care | **Intensive care | ||
**Inotropic and [[ventilation]] support | **[[Inotropic]] and [[ventilation]] support | ||
If attempts at an endoscopic papillotomy EP or percutaneous transhepatic drainage of the [[common bile duct]] is 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 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> | If attempts at an endoscopic papillotomy EP or percutaneous transhepatic drainage of the [[common bile duct]] is 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 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> | ||
Revision as of 18:39, 20 September 2016
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Cholangitis Microchapters |
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Treatment |
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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 the preferred technique to improve the outcome 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 options.[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 EP or percutaneous transhepatic drainage of the common bile duct is 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 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.