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Acute cholangitis secondary to hepatolithiasis.

S T Fan1, E C Lai, F P Mok

  • 1Department of Surgery, University of Hong Kong, Queen Mary Hospital.

Archives of Surgery (Chicago, Ill. : 1960)
|August 1, 1991
PubMed
Summary

In acute cholangitis from hepatolithiasis, 30% of patients needed emergency biliary decompression. High pulse rate and low platelet count at admission predict this need, guiding early intervention for high-risk patients.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Surgical Gastroenterology

Background:

  • Acute cholangitis secondary to hepatolithiasis presents a significant clinical challenge.
  • A subset of patients requires urgent intervention due to disease severity.

Purpose of the Study:

  • To identify factors predicting the failure of conservative treatment in acute cholangitis due to hepatolithiasis.
  • To determine predictors for the necessity of emergency biliary decompression.

Main Methods:

  • Retrospective analysis of 88 patients with acute cholangitis secondary to hepatolithiasis.
  • Logistic regression analysis of clinical, hematological, and biochemical data.

Main Results:

  • Thirty percent (26/88) of patients required emergency intervention for septicemic shock, persistent fever, or peritonitis.

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  • Concomitant extrahepatic obstruction was more frequent in patients needing emergency procedures.
  • Maximum pulse rate >100 bpm (RR 2.8) and platelet count <150 x 10(9)/L (RR 5.2) independently predicted the need for emergency intervention.

    • Conclusions:

    • Elevated pulse rate and low platelet count are significant predictors for emergency biliary decompression in acute cholangitis due to hepatolithiasis.
    • These findings can aid in identifying high-risk patients who may benefit from early therapeutic procedures.