In:
International Surgery, International College of Surgeons, Vol. 105, No. 1-3 ( 2021-01-01), p. 667-678
Abstract:
The incidence of biliary infections is rising worldwide and has become one of the main reasons for emergency admissions. Methods This is a narrative review of the literature emphasizing news concepts related to the early management of biliary diseases. Results The bacteriology is frequently polymicrobial, with a progressive increase of multidrug resistant bacteria. The form of presentation is variable, and the mortality rate may reach 20%. When cholecystitis or cholangitis is suspected, ultrasound is the gold standard imaging test. Depending on the severity of presentation, local resistances, and risk factors for multiresistant organisms, the most appropriate empirical antibiotic treatment must be initiated. In acute cholecystitis, cholecystectomy plays the main therapeutic role. In patients not suitable for surgery, percutaneous cholecystostomy is a valid alternative for source control. Treatment of severe cholangitis is based on the drainage of the bile duct and antibiotic therapy. Conclusions Biliary infections are serious conditions that can lead to sepsis and death. The introduction of new internationally accepted guidelines, based on clinical presentation, laboratory tests, and imaging, provides a platform for their timely diagnosis and management. Early severity assessment, initiation of intravenous antibiotics, and source control are fundamental to improving morbidity and mortality.
Type of Medium:
Online Resource
ISSN:
0020-8868
DOI:
10.9738/INTSURG-D-20-00046.1
Language:
English
Publisher:
International College of Surgeons
Publication Date:
2021
detail.hit.zdb_id:
2151533-5
