[Early cholangitis complicating percutaneous biliary drainage]

To evaluate the prevalence, severity and outcome of cholangitis within two months after percutaneous transhepatic biliary drainage.

One hundred and nineteen patients with obstructive jaundice but no septic symptoms underwent biliary drainage for biliary decompression. Biliary obstruction was malignant in 87 patients and benign in 32 patients. Clinical and biological criteria were developed to confirm and grade the cholangitis. Based on these, the prevalence, severity and outcome of cholangitis was determined and analysed through review of clinical records.

All patients had successful biliary drainage and internal drainage. Nine patients (7.5%) developed cholangitis after biliary drainage, three (2.5%) being of the severe type. Of these, 8 had malignant obstruction. All three patients with severe cholangitis had malignant obstruction. All patients with cholangitis except one (0.8%) responded to antibiotic and supportive therapy.

Severe cholangitis occurring within two months following PBD for obstructive jaundice was uncommon. It tended to occur in patients with malignant obstruction. Although most responded favorably to medical treatment, post procedural sepsis must be handled with great care since it is life-threatning.