Endoscopic Management of Acute Cholangitis

Abstract

Acute cholangitis is a systemic infectious condition with acute inflammation and infection in the bile duct. The incidence of acute cholangitis ranges from 0.3 to 1.6% with a proportion of severe cholangitis that reaches 12.3%. A proportion of acute cholangitis occurs after ERCP in about 0.5-2.4%. The most common cause of acute cholangitis is common bile duct stone. Mortality rate in severe cholangitis remains significant without appropriate management. Advances in intensive care, antibiotic regimens and biliary drainage techniques have dramatically improved the mortality rate of more than 50% prior to the 1970s to less than 10% in the 1980s. Anyway still it remains about 3-10%. Clinical presentation ranges from mild symptoms to severe life-threatening with septic shock conducting rapidly to death;