The risk factors for development and demonstration of an acute cholangitis in patients, suffering benign obstruction of extrahepatic biliary ducts
Objective. Determination of factors, promoting development of an acute cholangitis (ACH) or constituting its signs in benign obstruction of extrahepatic biliary ducts (EHBD).
Materials and methods. Retrospectively 144 observations of benign obstruction of extrahepatic biliary ducts, ACH was noted in 17 observations. Comparison of prevalence of various factors and signs in the patients with ACH and without it was accomplished.
Results. The difference was statistically proven (p < 0.05) between such indices: hyperthermy, Charcot’s triad, leucocytosis, content of stab neutrophils, level of general bilirubin, the blood amylase activity, the gallbladder wall thickness, presence of excluded gallbladder, fixated calculus of duodenal papilla magna (DPM), dimensions of DPM. The differences were absent (p > 0.05) between following indices: gender, age, BMI, presence of abdominal pain syndrome, cholecystectomy in anamnesis, the gallbladder volume, cause of obstruction, dilation of hepaticocholedochus, endoscopic papillosphincterotomy in anamnesis, presence of peripapillary diverticulum and an acute biliary pancreatitis.
Conclusion. The risk factors for development of ACH were: a general bilirubin level 70 mcmol/l and higher, the gallbladder wall thickening up to 4 mm and more, the excluded gallbladder, fixated calculus of DPM, dimension of DPM 15 mm and more. Signs of an ACH were: hyperthermy, presence of Charcot’s triad, leucocytosis 9 × 109 in 1 l and higher, enhancement of content of stab neutrophils up to 7% and higher, hyperamylasemia.
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