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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2021; 12(03): 127-132
DOI: 10.1055/s-0041-1739561
Research Article

Profile and Outcome of Patients with Acute Cholangitis in a Tertiary Center in South India

Autoren

  • Prasanth Raghhupatruni

    1   Department of Gastroenterology, Amrita Institute of Medical Sciences, Amrita Viswa Vidyapeetham, Kochi, Kerala, India

  • Rajesh Gopalakrishna 

    1   Department of Gastroenterology, Amrita Institute of Medical Sciences, Amrita Viswa Vidyapeetham, Kochi, Kerala, India

  • Vinodkumar Ankarath

    1   Department of Gastroenterology, Amrita Institute of Medical Sciences, Amrita Viswa Vidyapeetham, Kochi, Kerala, India

  • Shine Sadasivan

    1   Department of Gastroenterology, Amrita Institute of Medical Sciences, Amrita Viswa Vidyapeetham, Kochi, Kerala, India
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Abstract

Background The mainstay of management of acute cholangitis includes endoscopic or percutaneous biliary drainage and antimicrobial therapy. We aimed to study the profile and outcomes among patients with acute cholangitis who underwent endoscopic biliary drainage at our center.

Methods Seventy consecutive patients with acute cholangitis diagnosed and managed as per the Tokyo Guidelines 2018 for acute cholangitis between June 1, 2018 to December 31, 2019 were prospectively studied. Clinical, etiological and microbial profile, therapy, and patient outcomes were analyzed.

Results Choledocholithiasis (54.3%) and benign biliary stricture (28.6%) and malignancy (17.1%) were common etiological factors. Thirteen patients (18.6%) had underlying chronic liver disease. Moderate-to-severe cholangitis was seen in 67.7% of patients with high and very high grade as compared with 54.5% with medium grade of Charlson comorbidity index (CCI) and 41.2% of patients with low grade of CCI. Elevated C-reactive protein, low albumin, and prolonged international normalized ratio were associated with severe cholangitis. Bile culture was positive in 62.9% and blood culture was positive in 15.7% of patients. Bile cultures were predominantly polymicrobial in contrast to blood cultures (53.8 vs. 18%). Escherichia coli was the predominant isolate in blood and bile. Multidrug resistant (MDR) organisms were seen in 79.5% of positive bile cultures.

Conclusions A positive blood or bile culture, but not presence of multiple organisms or presence of MDR organisms in bile, was associated with severity of cholangitis. There was no mortality among these patients in-hospital or at 28-days.

Keywords

ERCP - PTBD - bacterobilia - bile culture


Publikationsverlauf

Artikel online veröffentlicht:
17. November 2021

© 2021. Society of Gastrointestinal Endoscopy of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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