Management of acute cholecystitis and acute cholangitis in emergency setting
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- 作者：Kui-Hin Liau (1)
Catherine Teh (2)
Alejandro Serrablo (3) - 关键词：Acute cholangitis ; Acute cholecystitis ; Emergency ; Management
- 刊名：Central European Journal of Medicine
- 出版年：2014
- 出版时间：June 2014
- 年：2014
- 卷：9
- 期：3
- 页码：357-369
- 全文大小：1,099 KB
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Catherine Teh (2)
Alejandro Serrablo (3)
1. Nexus Surgical Associates, Mt Elizabeth Hospital & Mt Elizabeth Novena Specialist Centre, Singapore, Singapore
2. St Luke Medical Centre, Manila, Philippines
3. Hospital Universitario Miguel Servet, Zaragoza, Spain - ISSN：1644-3640
文摘
Acute biliary infection (acute cholecystitis and acute cholangitis) is one of the common emergency conditions which carries significant morbidity and mortality. The risk factors are often associated with gallstones, biliary stasis and bile infection. Gram-negative bacteria are frequent isolates from bile and blood cultures in infectious cholangitis. Endotoxaemia from the gram-negative microbes results in circulatory shock and organ dysfunction. Therefore, prompt diagnosis with severity stratification and recognition of its potential rapid progression to life-threatening shock and multi-organ failure ensure execution of the three fundamental interventions in the initial management strategy, namely: resuscitation to support the organ, antimicrobial therapy and biliary decompression drainage to control the infection. This is the core principle in the management of severe acute cholangitis.