Abstract
Elderly patients with acute obstructive suppurative cholangitis (AOSC) have a very poor prognosis due both to the gradual development of symptoms and to acute exacerbation, resulting in a condition that is both severe and irreversible. In this study, we evaluated the clinical characteristics and effects of biliary drainage in patients with AOSC treated in our department, with special attention being focused on patients aged 70 years or more. Of 21 patients with AOSC, 7 (33.3%) were more than 70 years of age. All 7 had choledocholithiasis. In all patients with choledocholithiasis, in this study. AOSC was observed in 23.3% of those who were more than 70 years of age (7/30). In elderly patients with AOSC, typical symptoms are often absent, and the severity of the disease is difficult to determine based on the results of examination alone. Since early diagnosis of AOSC and appropriate biliary drainage from the onset of AOSC are extremely important, clinical findings should be examined with the utmost care.
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References
Gould RJ, Vogelzang RL, Neiman HL, Pearl GJ, Poticha SM (1985) Percutaneous biliary drainage as an initial therapy in sepsis of the biliary tract. Surg Gynecol Obstet 160:523–527
Himal HS, Lindsay T (1990) Ascending cholangitis: Surgery versus endoscopic or percutaneous drainage. Surgery 108:629–634
Huang MH, Ker CG (1988) Ultrasonic guided percutaneous transhepatic bile drainage for cholangitis due to intrahepatic stones. Arch Surg 123:106–109
Lin XZ, Chang KK, Shin JS, Lin CY, Lin PW, Yu CY, Chou TC (1993) Emergency endoscopic nasobiliary drainage for acute calculous suppurative cholangitis and its potential use in chemical dissolution. J Gastroenterol Hepatol 8:35–38
Noro T, Yamashiro M, Nakayama N, Hashimoto H, Takahashi T, Hino Y, Hirajima N, Hioki N (1982) The status quo and treatment of biliary infection in the aged (in Japanese). Tan to Sui (J Bil Pancr) 3:7–14
Kinoshita M, Ono S, Tamakuma S (1992) Acute suppurative obstructive cholangitis in the aged (in Japanese). KAN TAN SUI (Hep Bil Pancr) 25:471–479
Csendes A, Diaz JC, Burdiles P, Maluenda F, Morales E (1992) Risk factors and classification of acute suppurative cholangitis. Br J Surg 79:655–658
Lai EC, Paterson IA, Tam PC, Choi TK, Fan ST, Wong J (1990) Severe acute cholangitis: The role of emergency nasobiliary drainage. Surgery 107:268–272
Lai EC, Tam PC, Paterson IA, Ng MM, Fan ST, Choi TK, Wong J (1990) Emergency surgery for severe acute cholangitis: The high-risk patients. Ann Surg 211:55–59
Maluenda F, Csendes A, Burdiles P, Diaz J (1989) Bacteriological study of choledochal bile in patients with common bile duct stones, with or without acute suppurative cholangitis. Hepato-Gastroenterol 36:132–135
Lipsett PA, Pitt HA (1990) Acute cholangitis. Surg Clin North Am 70:1297–1312
Nunez D Jr, Guerra JJ Jr, Al-Sheikh WA, Russell E, Mendez G Jr (1986) Percutaneous biliary drainage in acute suppurative cholangitis. Gastrointest Radiol 11:85–89
Atomi Y, Kuroda K, Morioka Y (1982) Biliary drainage for acute cholangitis (in Japanese). Tan to Sui (J Bil Pancr) 3:61–70
Kawarada Y, Kawamura K, Sanda M (1984) Operative timing for acute cholecystitis and acute cholangitis (in Japanese). Geka Chiryo (Surg Ther) 51:175–181
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Higashiguchi, T., Kawarada, Y., Yokoi, H. et al. Clinical evaluation and treatment in elderly patients with acute obstructive suppurative cholangitis. J Hep Bil Pancr Surg 3, 23–26 (1996). https://doi.org/10.1007/BF01212775
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DOI: https://doi.org/10.1007/BF01212775