| Theme |
The Present State of Management of Acute Cholangitis and Cholecystitis |
| Title |
Acute Cholangitis Management Strategies |
| Author |
Seiki Kiriyama |
Department of Gastroenterology, Ogaki Municipal Hospital |
| Author |
Takashi Kumada |
Department of Gastroenterology, Ogaki Municipal Hospital |
| Author |
Makoto Tanikawa |
Department of Gastroenterology, Ogaki Municipal Hospital |
| Author |
Yasuhiro Hisanaga |
Department of Gastroenterology, Ogaki Municipal Hospital |
| Author |
Hidenori Toyota |
Department of Gastroenterology, Ogaki Municipal Hospital |
| Author |
Akira Kanamori |
Department of Gastroenterology, Ogaki Municipal Hospital |
| Author |
Toshifumi Tada |
Department of Gastroenterology, Ogaki Municipal Hospital |
| Author |
Shusuke Kitabatake |
Department of Gastroenterology, Ogaki Municipal Hospital |
| [ Summary ] |
Acute cholangitis is the result of biliary infection progression to a systemic inflammatory response caused by cholangiovenous or cholangiolymphatic reflux of infected bile associated with increased intraductal pressure in the bile duct. Therefore, medical treatment should include not only administration of antimicrobial agents but also biliary drainage of the bile duct to reduce intraductal pressure. Practice guidelines include acute cholangitis management strategies based on severity assessment. Antimicrobial therapy is often sufficient for initial medical treatment of most mild acute cholangitis cases. For cases of moderate acute cholangitis, defined as acute cholangitis not complicated by organ dysfunction but with risk of progression to severe cholangitis, early biliary drainage is recommended in addition to initial medical treatment. Appropriate organ support is necessary. addition to urgent biliary drainage and initial medical treatment. for cases of severe acute cholangitis, defined as acute cholangitis complicated by organ dysfunction. Treatment of the causative agent should be performed after improvement of patient general condition in moderate or severe acute cholangitis. |