Acute obstructive suppurative cholangitis 35 cases of surgical treatment of.docVIP

 PAGE \* MERGEFORMAT 9 Acute obstructive suppurative cholangitis 35 cases of surgical treatment of Acute obstructive suppurative cholangitis (ACST), there may be a serious shock, sepsis and liver bad, kidney failure and other multi-organ failure (MOF), the treatment is extremely difficult, is the most important benign biliary tract disease, the most direct cause of death. China reported that its mortality rate as high as 13.7% [1]. In recent years, our hospital by taking quick and effective anti-shock treatment, and with appropriate and timely surgical MOF control measures such as treatment ACST 35 patients with satisfactory results are reported as follows. A clinical data 1.1 General Information In our hospital from 1985 to 2004 a total of 20 years admitted with acute obstructive suppurative cholangitis (ACST) 35 cases, of which 13 males and 22 females; aged 32 to 73 years, with an average age of 53. 1.2 Clinical manifestations Past have different levels of biliary history of repeated infection, including a 10-year history of less than 8 cases, 11 to 20 years in 20 cases, 21 years in 7 cases, the longest up to 33 years. There is one or more times 9 patients with a history of biliary tract surgery. The onset to treatment time of 2 ~ 6 days. Clinical manifestations of 31 cases of right upper quadrant pain, jaundice, 32 cases; Murphy sign positive in 26 cases, Charcot triad in 15 cases; associated with toxic shock in 15 cases, there are seven cases of altered mental status; Tamp;gt; 39 ℃ 12 Li, amp;lt;37 ℃ 5 cases. Laboratory examination: WBCamp;gt; 20 * 109 / L 24 cases; 19 cases of abnormal liver function, kidney function abnormal in 11 cases. Blood culture was positive in 13 cases. Purulent bile is associated with significantly increased pressure inside the bile duct in 31 cases (88.6%). Complications were 19 cases, accounting for 54.3%, some patients have two or more complications, including cardiovascular disease, nine cases of times, eight cases of