The High Risk Factor For Acute Suppurative Cholangitis After Cholecystectomy

Objective Acute suppurative cholangitis (ASC),is a life-threatning condition that mustbe treated with appropriate and timely management. ASC is a severe form of acutecholangitis. The purpose of this study was to identify the clinical factors that predisposepatients to ASC after Cholecystectomy.Methods We retrospectively investigated181patients, who were admitted to Ningxiapeople’s Hospital and The affiliated Hospital of Ningxia medical university between January2007and July2010for acute cholangitis after Cholecystectomy. All patients underwentERCP or open gallstone remove surgery. The clinical factors that could be assessed uponadmission were analyzed to identify the risk factors for the development of ASC aftercholecystectomy.Results There were181patients in this study,44(24.3%) presented with ASC. Thefollowing were found to be independent risk factors for the development of ASC: Advancedage (>70years; p=0.002), Long-term smoking (p=0.008), Common bile duct stone (p=0.01),Peripapillary diverticulum (P=0.016).The most commonly isolated organisms in bile culturewere Enterococcus species, Escherichia coli, and Klebsiella species.Conclusion Advanced age (>70years), Long-term smoking,Common bile duct stone,and Peripapillary diverticulum were identified as independent risk factors for thedevelopment of ASC in patients after cholecystectomy. These results suggest that emergencybilary drainage and open surgery is benefical in patient with these factors.