[Specifics of surgical approach in purulent cholangitis]

When analysing the results of examination of 773 patients with obstructive jaundice (OJ) of benign genesis, purulent cholangitis (PC) was revealed in 323. In PC diagnosis, the ultrasound study is a valuable adjunctive method. In presence of the clinical signs of PC in patients and absence of the effect from conservative therapy, and as well in preservation of the high indices of bilirubinemia, the early operative treatment performed, as a rule, no later than 48 h after hospitalization is indicated. PC in patients with OJ is most frequently caused by choledocholithiasis. The causative agents of PC are represented by aerobic and anaerobic microorganisms, requiring the use of broad spectrum antibiotics before the operation and 6-12 h after it. Adequate restoration of bile passage and pathogenetically substantiated local influencing upon the inflammatory process in the bile ducts are tasks of operative intervention. Direct administration into the bile ducts of antibiotics and antiinflammatory preparations, in particular of quercitrol, via the external drain of the common bile duct is expedient.