Timing of endoscopic treatment for acute cholangitis of severe type accompanying multiple organ dysfunction syndrome / 中国微创外科杂志

ABSTRACT

Objective To investigate the timing of endoscopic treatment for acute cholangitis of severe type(ACST) accompanying multiple organ dysfunction syndrome(MODS).Methods On the basis of routine medical measures,such as oxygen inhalation and antishock treatment,9 patients with ACST accompanying MODS were given endoscopic retrograde cholangiopancreatography(ERCP) with endoscopic sphincterotomy(EST),or endoscopic nasobiliary drainage(ENBD) after needle electrode fenestration and stone removal with basket,or endoscopic retrograde biliary drainage(ERBD) with internal stent.Results The endoscopic treatment was successfully accomplished within 35 min in all the 9 patients.Seven patients at stage 1~2 of MODS rehabilitated at 1~2 weeks after treatment,while 2 patients at stage 3 of MODS died in 2 weeks.Conclusions Endoscopic treatment should be applied to patients with ACST at stage 1~2 of MODS as early as possible.For patients with ACST at stage 3~4 of MODS,however,emphasis should be laid on the prevention of organ failure and the reversion of organ functions.