| Theme | Digestive Diseases Related to Bacteria -- To Understand Etiology and Control of Clinicopathological Conditions | |
|---|---|---|
| Title | Acute Biliary Infectious Disease | |
| Publish Date | 2007/08 | |
| Author | Yasutoshi Kimura | First Department of Surgery, Sapporo Medical University |
| Author | Takayuki Nobuoka | First Department of Surgery, Sapporo Medical University |
| Author | Masashi Imamura | First Department of Surgery, Sapporo Medical University |
| Author | Toru Mizuguchi | First Department of Surgery, Sapporo Medical University |
| Author | Tomohisa Furuhata | First Department of Surgery, Sapporo Medical University |
| Author | Koichi Hirata | First Department of Surgery, Sapporo Medical University |
| [ Summary ] | Acute biliary infectious diseases are classified broadly into two categories, one is acute cholangitis and the other acute cholecystitis. The former is a systemic infectious disease which requires prompt treatment and has a significantly high mortality rate. Acute cholangitis and cholecystitis primary originate from stones in the bile ducts and gallbladder. Acute cholecystitis has other causes such as ischemia, chemicals in biliary secretions, motility disorders associated with drugs, infections with microorganisms, protozoon or parasites, collagen disease or allergic reactions. Acute acalculous cholecystitis may be associated with an adjacent operation, trauma, burns, multisystem organ failure or parenteral nutrition. Factors associated with the onset of cholelithiasis include obesity, age and drugs such as oral contraceptives. The reported mortality rate of less than 10 % for acute cholecystitis gives the impression that it is not a fatal disease except in elderly and / or acalculous cases. However, there are reports of high mortality with cholangitis, although the mortality differs greatly depending on the year of report and the severity of the disease. Even reports published in or after the 1980's indicate high mortality rates, ranging from 10 to 30 % of patients, with multi-organ failure as a major cause of death. Since many of the reports concerning acute cholecystitis and cholangitis use different standards, comparisons are difficult. Variations in treatment and risk factors, influencing the mortality rates, indicate the necessity of standardized diagnostic, treatment and severity assessment criteria. |
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