[Acute cholangitis due to bile duct stones: clinical analysis of 85 cases]

A retrospective review of 85 patients with acute calculous cholangitis who underwent emergency surgery (n = 85) was carried out. There were 28 men and 57 women and their mean age was 61.4 years. All patients had abdominal pain, 81% had chills and fever, 75% had clinical jaundice, and 28.2% were in shock. There were 48 severe acute cholangitis (group 1) and 37 acute cholangitis (group 2). The incidence of a positive bile culture in group 1 was 100% (28/28) and that of group 2 was 85% (17/20). The morbidity and mortality in group 1 was 43.8% and 20.8%, respectively. Five patients (13.5%) in group 2 had simple wound infection, and there was no severe complications or death. A significantly lower platelet count was documented in group 1 (86.5 +/- 40.7 x 10(9)/L) as compared with group 2 (159.9 +/- 63.9 x 10(9)/L) (P < 0.001). It is suggest that platelet count less than 90 x 10(9)/L at the time of admission or preoperation may serve as a guideline for identifying high-risk patient in early surgical intervention.