Recently, our department for a referral to the hospital from the state of elderly patients with acute suppurative cholangitis and septic sho
Recently, our department for a referral to the hospital from the state of elderly patients with acute suppurative cholangitis and septic shock patients, the success of the emergency endoscopic treatment, successfully saved the patient's life.
The female patient, 68 years old, the previous May 2004 had diabetes and renal failure of renal transplantation; 5 days before referral for right upper abdominal pain to local hospital in-patient treatment, followed by fever, jaundice, temperature fluctuation in the 38.5C - 39.5C, 19.17x109/L in peripheral blood white cells, neutrophils by 94.31%; B ultrasound and CT examination in the diagnosis of common bile duct stones and bile duct, anti infection, gallbladder and other conservative treatment, the patient did not improve surgery because of the patient's condition can not tolerate surgery, suggest continued medical treatment, the patient's condition and weight, and low blood pressure, shortness of breath and other symptoms of septic shock in fifth days of onset, transferred to our department contact. When the patient into the upper abdominal pain, fever, jaundice, shortness of breath, low blood pressure, low oxygen saturation, considered as "acute obstructive suppurative cholangitis and septic shock, emergency endoscopic treatment, bile duct drained large turbid purulent fluid, abdominal pain disappeared, the body temperature drop, jaundice subsided gradually. There is significant improvement.
Acute obstructive suppurative cholangitis (acute obstructive suppurative cholangitis, AOSC) a serious disease, prone to septic shock and multiple organ failure. In the past, more than 40% cases were treated by surgical drainage of biliary tract. The mortality rate was as high as 20%. In recent years, with the improvement of endoscopic technology and the accumulation of experience, the success rate of endoscopic treatment of biliary tract disease has been greatly improved, which is better than that of the patients. Because AOSC is caused by obstruction or stenosis of bile duct, it is difficult for the antibiotics to enter the biliary system due to poor bile excretion. The traditional operation method with common bile duct T tube drainage, but because patients were older, liver function damaged to varying degrees, often accompanied by serious diseases, surgical risk; some patients with repeated biliary surgery, extensive intra-abdominal adhesions make operation easy to damage the surrounding organs, high morbidity and mortality in emergency surgery. Endoscopic treatment for acute obstructive suppurative cholangitis is the value of a very small trauma, can solve the obstruction of bile duct, is undoubtedly an excellent means of treatment, fully embodies the advantages of minimally invasive treatment. Endoscopic treatment of elderly patients with acute suppurative cholangitis and surgical curative effect is similar, but the security is obviously higher than the latter.
I took the lead in developing the technology department in the province, has successfully treated cases of patients with acute obstructive suppurative cholangitis, and most patients get medical staff approval. With the deepening of the work, we believe that there will be a large number of patients and medical staff to understand and accept emergency endoscopic treatment of biliary diseases, access to minimally invasive treatment of safe and effective treatment.