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Article: Severe acute cholangitis: The role of emergency nasobiliary drainage

TitleSevere acute cholangitis: The role of emergency nasobiliary drainage
Authors
Issue Date1990
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/surg
Citation
Surgery, 1990, v. 107 n. 3, p. 268-272 How to Cite?
AbstractThe role of emergency endoscopic nasobiliary drainage (NBD) in the management of severe acute cholangitis was evaluated by comparing the outcome of 15 patients who underwent the procedure as an initial treatment with that of 20 patients who underwent emergency surgery. Biliary sepsis was sucessfully controlled without complication in all 15 patients by insertion of a 7F nasobiliary catheter through a limited papillotomy. Subsequent definitive elective treatment included endoscopic stone clearance (n = 6), common duct exploration (n = 8), and bili-enteric reconstruction (n = 1). Among the 20 patients who had surgical treatment, cholecystectomy (n = 11), cholecystostomy (n = 1), and transphatic intubation (n = 1) were done in addition to common duct exploration. Although patients undergoing endoscopic NBD were significantly older (75.3 years vs 60.1 years; p < 0.05) and more jaundiced (total bilirubin, 120.3 mmol/L vs 70.4 mmol/L; p < 0.05), comparable morbidity (40% vs 65%) and mortality (6.7% vs 20%) was observed. Initial endoscopic NBD provides a safe and effective therapeutic option for the management of fulminant biliary sepsis. Among patients with complicated ductal anatomy, endoscopic NBD should first be attempted because, when successful, definitive reconstruction may be performed on an elective basis. The value of its routine application for all patients, however, remains to be validated by further clinical studies.
Persistent Identifierhttp://hdl.handle.net/10722/172628
ISSN
2015 Impact Factor: 3.309
2015 SCImago Journal Rankings: 1.620
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLai, ECSen_HK
dc.contributor.authorPaterson, IAen_HK
dc.contributor.authorTam, PCen_HK
dc.contributor.authorChoi, TKen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2012-10-30T06:23:52Z-
dc.date.available2012-10-30T06:23:52Z-
dc.date.issued1990en_HK
dc.identifier.citationSurgery, 1990, v. 107 n. 3, p. 268-272en_HK
dc.identifier.issn0039-6060en_HK
dc.identifier.urihttp://hdl.handle.net/10722/172628-
dc.description.abstractThe role of emergency endoscopic nasobiliary drainage (NBD) in the management of severe acute cholangitis was evaluated by comparing the outcome of 15 patients who underwent the procedure as an initial treatment with that of 20 patients who underwent emergency surgery. Biliary sepsis was sucessfully controlled without complication in all 15 patients by insertion of a 7F nasobiliary catheter through a limited papillotomy. Subsequent definitive elective treatment included endoscopic stone clearance (n = 6), common duct exploration (n = 8), and bili-enteric reconstruction (n = 1). Among the 20 patients who had surgical treatment, cholecystectomy (n = 11), cholecystostomy (n = 1), and transphatic intubation (n = 1) were done in addition to common duct exploration. Although patients undergoing endoscopic NBD were significantly older (75.3 years vs 60.1 years; p < 0.05) and more jaundiced (total bilirubin, 120.3 mmol/L vs 70.4 mmol/L; p < 0.05), comparable morbidity (40% vs 65%) and mortality (6.7% vs 20%) was observed. Initial endoscopic NBD provides a safe and effective therapeutic option for the management of fulminant biliary sepsis. Among patients with complicated ductal anatomy, endoscopic NBD should first be attempted because, when successful, definitive reconstruction may be performed on an elective basis. The value of its routine application for all patients, however, remains to be validated by further clinical studies.en_HK
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/surgen_HK
dc.relation.ispartofSurgeryen_HK
dc.subject.meshAcute Diseaseen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshCholangitis - Microbiology - Mortality - Therapyen_US
dc.subject.meshDrainage - Methodsen_US
dc.subject.meshEmergenciesen_US
dc.subject.meshEndoscopyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.titleSevere acute cholangitis: The role of emergency nasobiliary drainageen_HK
dc.typeArticleen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid2309146-
dc.identifier.scopuseid_2-s2.0-0025231526en_HK
dc.identifier.volume107en_HK
dc.identifier.issue3en_HK
dc.identifier.spage268en_HK
dc.identifier.epage272en_HK
dc.identifier.isiWOS:A1990CR67300006-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLai, ECS=36932159600en_HK
dc.identifier.scopusauthoridPaterson, IA=7102922229en_HK
dc.identifier.scopusauthoridTam, PC=7202539419en_HK
dc.identifier.scopusauthoridChoi, TK=7202770029en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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