par Bourgeois, Nadine 
;Jeanmart, Jacques ;Costamagna, Guido
Référence Acta endoscopica, 16, 4, page (195-203)
Publication Publié, 1986
;Jeanmart, Jacques ;Costamagna, GuidoRéférence Acta endoscopica, 16, 4, page (195-203)
Publication Publié, 1986
Article révisé par les pairs
| Résumé : | A biliary infection has to be managed immediately, with sufficient drainage and adequate antibiotherapy. We looked retrospectively at 40 patients, admitted for acute cholangitis attributed to biliary stones. The represent 16% of inpatients suffering from choledocholithiasis. An ERCP followed by a sphincterotomy was performed in all cases, with partial or total extraction of biliary calculi. Sufficient drainage was always achieved. In 92% of the cases, biliary decompression allowed an immediate clinical improvement with a fall to normal of the bilirubin levels within 5 days. Endoscopy-related morbidity was 12%; no complication led to surgery. There is no mortality. In 84% of the cases, gallbladder stones were associated with choledocholithiasis. Old people (mean age: 80) without signs of acute cholecystitis - 16 patients - did not undergo cholecystectomy. Immediate endoscopic management is efficient and rather innocuous; it is proposed as a first attempt in case of acute cholangitis. |
