Acute cholangitis usually refers to acute inflammation of the biliary system caused by bacterial infection, and the management includes non-surgical treatment, emergency biliary decompression and drainage, and follow-up treatment.
1. Non-surgical treatment: maintain effective venous access and restore blood volume; apply sufficient antibiotics in combination, firstly use drugs against gram-negative bacilli and anaerobic bacteria (e.g., cefoperazone, cefozoxime, etc.); correct the disorders of water-electrolyte and acid-base balance; and provide symptomatic treatments, such as lowering the temperature and supplementing all kinds of nutrients, etc. The drugs should be applied under doctor’s supervision. Drugs should be applied under the guidance of a doctor.
2. Emergency bile duct decompression and drainage: only by lowering the pressure in the bile duct can the reflux of bile or bacteria to the blood be terminated and the deterioration of the condition be blocked, common surgical methods include endoscopic nasobiliary drainage, percutaneous hepatic puncture biliary drainage, etc.
3. Follow-up treatment: Decompression and drainage surgery does not completely remove the cause of the disease, and may lead to recurrent episodes if no follow-up treatment is given. When the patient’s general condition recovers, complete surgical treatment should be carried out after 1-3 months according to the patient’s primary cause, such as choledochotomy, retrograde cholangiopancreatography and lithotripsy.
Patients with acute cholangitis should be sent to the hospital immediately, as the onset of this disease is acute and delays can lead to serious consequences.