Updates in the Management of Cholecystitis, Cholangitis, and Obstructive Jaundice

Abstract

The treatment of hepatic and biliary emergency represents one of the challenges for the acute care surgeons, endoscopists, and interventional radiologists. The complexity of the biliary anatomy and the potentially high risk of bleeding and iatrogenic damage during invasive procedures make the staged or definitive management of hepatic and biliary emergency a risky undertaking. Cholecystitis, cholangitis, and obstructive jaundice may present with different clinical pictures; nevertheless, they may have common aetiological aspects (chemical inflammation, infection, and/or obstruction), may coexist, and may evolve one into each other. The definition of diagnostic criteria, the timing of treatment, the treatment options including the antimicrobial therapy, and the patients’ risk stratification are of paramount importance, in particular in the perspective of the therapy that has to be prompt and effective. In this chapter, recent updates in the management of cholecystitis, cholangitis, and obstructive jaundice will be discussed taking into account the different but synergistic points of view of the surgeons, endoscopists, and interventional radiologists.