Endoscopic and radiologic interventions as the leading causes of severe cholangitis in a tertiary referral center - 18/08/11
, Yaman Tekant, M.D. a, Orhan Bilge, M.D. a, Koray Acarlı, M.D. a, Aydın Alper, M.D. a, Ali Emre, M.D. a, Izzet Rozanes, M.D. b, Halit Ozsut, M.D. c, Orhan Arıogul, M.D. a
Corresponding author. Tel.: +90-212-635-3082; fax: +90-212-635-3082.Abstract |
Background |
Iatrogenic factors became the leading mechanisms of severe cholangitis in a referral center.
Patients and methods |
The records of the 58 patients treated for severe cholangitis between 1996 and May 2004 (inclusive) were evaluated.
Results |
The most frequent underlying diseases were periampullary tumors and mid-bile duct carcinomas (22), followed by proximal cholangiocarcinomas (14). The triggering mechanism was an incomplete endoscopic retrograde cholangiopancreatography (ERCP) in 32 patients, incomplete or inappropriate percutaneous transhepatic biliary drainage (PTBD) in 6, apparently successful ERCP and stenting in 1, and percutaneous transhepatic cholangiography in 1. PTBD was the treatment of choice (38). Mortality was 29% (17/58); the major causes were refractory sepsis (8) and incomplete biliary drainage (advanced tumor, technical failure, or hemobilia) (8).
Conclusions |
In this series composed predominantly of patients referred after development of sepsis, ERCP and PTBD complications were the leading mechanisms of severe cholangitis. Nonoperative biliary manipulations are invasive procedures with potentially fatal complications. The decisions to perform such procedures and periprocedural management are responsibilities of an experienced multidisciplinary team.
Le texte complet de cet article est disponible en PDF.Keywords : Cholangitis, Severe cholangitis, Endoscopic retrograde cholangiopancreatography, Percutaneous transhepatic biliary drainage
Plan
| This project was supported by the Research Fund of Istanbul University (Project No: BYP-527/09112004). |
Vol 189 - N° 6
P. 702-706 - juin 2005 Retour au numéro
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