Endoscopy 2021; 53(S 01): S217
DOI: 10.1055/s-0041-1724861
Abstracts | ESGE Days
ESGE Days 2021 Digital poster exhibition

Acute Cholangitis: Etiological and Therapeutic Aspects

Authors

  • Y Essadni

    1   Mohammed V University, Ibn Sina Hospital, Gastroenterology C, Rabat, Morocco

  • M Borahma

    1   Mohammed V University, Ibn Sina Hospital, Gastroenterology C, Rabat, Morocco

  • N Lagdali

    1   Mohammed V University, Ibn Sina Hospital, Gastroenterology C, Rabat, Morocco

  • I Benelbarhdadi

    1   Mohammed V University, Ibn Sina Hospital, Gastroenterology C, Rabat, Morocco

  • FZ Ajana

    1   Mohammed V University, Ibn Sina Hospital, Gastroenterology C, Rabat, Morocco
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Aims Acute cholangitis (AC) is an infection of the bile duct system. The main etiologies are biliary stones and malignant obstructions. The ultimate treatment is the endoscopic drainage (ED). Our work aimed to assess the etiological and therapeutic aspects of cholangitis in our center.

Methods This was a retrospective descriptive study including all patients hospitalized for AC according to Tokyo 2018 guidelines, over one year, and who underwent an ED.

Results Out of 148 EDs, 42 patients had AC. The average age was 62.8 years with feminine predominance (62 %) and sex ratio (F/M) of 0.62. Regarding etiologies, we recorded 50 % of AC had biliary stones (choledocholithiasis in 40.5 %, cystic duct stones in 2.4 %, and multiple common bile duct stones in 7.1 %), malignant obstructions represented 43 % of AC (pancreatic head tumor in 12 %, ampulloma in 9.5 %, hilar cholangiocarcinoma in 9.5 %, a gallbladder tumor in 4.8 %, 1 case of hepatic metastasis, 1 case of gastric tumor invading the CBD and 1 case of stent obstruction). Other etiologies were a case of liver hydatid cyst fistulized in the bile duct, one case of stenosing odditis, and one case with Sump syndrome. All patients received intravenous antibiotics as well as ED. Purulent cholangitis was found in 75 % of patients with cholangitis grade III, 25 % with grade II, and 10 % with grade I. Patients with biliary lithiasis underwent stones extraction, and a plastic stent was deployed in case of incomplete drainage or in case of purulent cholangitis (5 cases). For patients with malignant obstructions, a metallic stent was inserted. For infectious and inflammatory causes, patients underwent endoscopic sphincterotomy alone.

Conclusions AC is a serious complication of biliary obstruction. The etiologies remain dominated by lithiasis and tumors. ED is the treatment of choice and the management depends on the etiology and the grade of the cholangitis.

Citation Essadni Y, Borahma M, Lagdali N et al. eP370 ACUTE CHOLANGITIS: ETIOLOGICAL AND THERAPEUTIC ASPECTS. Endoscopy 2021; 53: S217.



Publication History

Article published online:
19 March 2021

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