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Published on: February 10, 2015
Systemic inflammatory response in acute cholangitis and after subsequent treatment
A N Kimmings1, S J van Deventer, Rauws EAJ
1Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
The European Journal of Surgery = Acta Chirurgica
|October 18, 2000
Summary
Acute cholangitis triggers a significant systemic inflammatory response, characterized by elevated endotoxin and cytokine levels. Endoscopic treatment effectively reduces these inflammatory markers within one week.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Immunology
Background:
- Acute cholangitis is a serious biliary tract infection.
- Systemic inflammation is a key feature of acute cholangitis.
Purpose of the Study:
- To quantify endotoxin and inflammatory mediator concentrations during acute cholangitis.
- To evaluate the impact of endoscopic treatment on these mediators.
Main Methods:
- Prospective study conducted at a university teaching hospital.
- Involved ten patients diagnosed with acute cholangitis.
- Measured plasma endotoxin, cytokines, and endotoxin binding proteins before and one week after endoscopic treatment.
Main Results:
- Endoscopic treatment significantly reduced bilirubin levels (p < 0.05).
- Plasma concentrations of tumor necrosis factor (TNF), interleukin-6 (IL-6), IL-8, IL-10, lipopolysaccharide binding protein, and soluble CD14 decreased significantly post-treatment (p < 0.03).
- Endotoxin levels remained unchanged, while bactericidal permeability increasing protein showed no significant change.
Conclusions:
- Acute cholangitis is associated with a substantial systemic inflammatory response.
- Endoscopic treatment leads to a dramatic reduction in systemic inflammation markers within one week.
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