Chirurgische Infektionen der Gallenblase und der Gallenwege

Zusammenfassung

Akute Cholezystitis und akute Cholangitis sind die wichtigsten chirurgischen Infektionen des Gallenwegssystems. Die frühzeitige laparoskopische Cholezystektomie ist die Therapie der Wahl bei akuter Cholezystitis. Morbidität und Spitalsaufenthalt sind günstiger nach laparoskopischer Operation, der frühzeitige Eingriff ermöglicht eine niedrige Konversionsrate. Bei der schweren akuten Cholangitis ist die Dekompression der entscheidende therapeutische Schritt, vorzugsweise endoskopisch oder transhepatisch. Bei Choledocholithiasis erfolgt die Sanierung durch Steinausräumung, bei Stenosen ist nach Gangableitung die weitere Abklärung und Therapie, je nach Diagnose, erforderlich.

Abstract

Acute cholecystitis and acute cholangitis are the most frequent surgical infections of the biliary tree. Early laparoscopic cholecystectomy is the treatment of choice in acute cholecystitis. Laparoscopic operation results in a shorter length of stay and less morbidity. Conversion rate is low in early laparoscopic cholecystectomy. Endoscopic or transhepatic decompression of the bile ducts is the treatment of choice in severe acute cholangitis. While the removal of stones is the causal therapy in choledocholithiasis, further diagnosis and consecutive therapy has to follow after decompression of bile duct stenosis.

Schlüsselwörter

Chirurgie - akute Cholezystitis - akute Cholangitis

Key words

surgery - acute cholecystitis - acute cholangitis

Literatur

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