Acute suppurative cholangitis(ASC) is a severe, lethal form of the extrahepatic biliary tract disease. The disease occurs most commonly in the elderly who have a history of mortality and morbidity, appropriate antibiotic therapy and immediate
surgical
drainage are essential. This study is and analysis of sixty-five cases of ASC confirmed by surgical exploration at the Department of Surgery Pusan National University Hospital during period from 1976 to 1990.
@ES The results obtained were summarized as follows:
@EN 1) The number of patients with ASC were 65 cases(6.4%) among biliary surgical cases in the same period, and the ratio of female to male was 2.6 : 1.
2) The most frequent symptoms and signs were RUQ pain(100%), jaundice(73.8%), fever and chills(72.3%) in order of frequency and preoperative laboratory data showed leukocytosis(83.1%), elevation of SGOT(73.8%), elevated serum bilirubin(90.8%),
elevated
alkaline phosphatase (80 ), prolonged prothrombin time(52.3%) and decreased platelet count(23.1%).
3) Cultured organisms of bile were E. coli(65.5%), proteus(22.4%), streptococcus(17.2%) and staphylococcus in order of frequency.
4) Preoperative diagnosis was accurate in 46.2%, and 29.2% of all patients with ASC had history of previous gallstone(92.3%).
5) Postoperative complications were pulmonary complication(15.4%), residual stone(12.3%), and bile leakage(9.2%) in order of frequency.
6) The mortality rate was increased according to the time by between onset of the disease and operation, and was 13.8%. The causes of death were sepsis(4 cases), acute renal failure(2 cases), pulmonary insufficiency(1 case), hemobilia(1 case)
and
hepatic failure(1 case) out of 65 cases with ASC.
|