OVERVIEW
OVERVIEW
Reflux cholangitis results from retrograde infection by bacteria in the intestine. With the exception of endobiliary fistulae, retrograde flow of intestinal contents into the biliary system after bilioenteric anastomosis is the most common cause. It can also occur after sphincter of Oddi dissection, especially if a large diameter metal stent is placed in the bile duct.
Insured or not
yes
Department of Medicine
Gastroenterology, General Surgery (Hepatobiliary Surgery)
Clinical symptoms
Chills, high fever, right upper abdominal pain, jaundice, etc.
Hazards
The disease is very likely to recur, affecting the patient’s life.
Examination
Blood routine, liver function test, ultrasound, CT, barium meal examination of upper gastrointestinal tract, transendoscopic retrograde cholangiography, etc.
Diagnosis
Diagnosis can be confirmed according to clinical features, whether barium reflux is seen in upper gastrointestinal tract barium meal examination and other auxiliary examinations.
Treatment principle
Anti-inflammatory and choleretic are the principles, and most patients need to be treated by surgical methods.
Curability
The prognosis is mostly good, but the reflux may recur.
Dietary advice
After surgery, the main diet should be fluids or easy-to-digest semi-fluids, and avoid spicy and stimulating foods.
Causes
Causes
Caused by retrograde infection of bacteria in the intestine. In addition to endobiliary fistula, too high, too small or narrow anastomosis of biliary and intestinal surgery can cause reflux cholangitis.
Symptoms and Diagnosis
Typical symptoms
1. recurrent chills, high fever and right upper abdominal pain. 2. jaundice. 3. yellowing of the skin and sclera due to bile duct obstruction. 4. pressure pain in the right upper abdomen.
Diagnostic basis
1. the presence or absence of typical clinical manifestations of cholangitis.2. whether barium reflux is seen on barium meal in the upper gastrointestinal tract and whether the clinical symptoms and signs of barium reflux disappear after correction of the reflux.3. CT or ultrasound of the liver and bile ducts.4. surgical exploration of the bile ducts for purulent bile and indigestible food debris, as well as for stones or parasites.
Treatment
Treatment guidelines
Based on the principle of anti-inflammatory and biliary benefit, most patients need to be treated by surgical methods.
Medication
Anti-inflammatory and choleretic drugs are used.
Surgery
Pyloric dissection and gastrojejunal anastomosis. Plasticization of the common hepatic duct and Y-type anastomosis of the jejunum and common hepatic duct. Extension of the length of the original jejuno-pancreatic and biliary anastomotic intestinal collaterals. Removal of the original choledochoduodenal anastomosis alone.
Prognosis
The prognosis is mostly favorable, but reflux is prone to recurrent episodes and most patients require surgery.
Questions you may be concerned about
Can you get reflux cholangitis after gallstone surgery?
It is possible to induce reflux cholangitis after gallstone surgery.
Reflux cholangitis is an inflammatory disease of the bile ducts caused by the invasion of bacteria from the intestines into the bile ducts. Reflux cholangitis occurs in patients after biliary surgery, the main reason is that the patient’s resistance is low after the surgery, and the intestinal bacteria may invade the bile ducts during or after the surgery.
The main symptoms of reflux cholangitis are high fever, abdominal pain, nausea and vomiting due to infectious inflammation, which may even lead to infectious shock if the infection is severe.
When the patient has the above symptoms, it is recommended to consult a doctor immediately, monitor the vital signs to see if they are stable, complete the abdominal CT, blood routine, blood biochemistry, infection indexes, coagulation indexes and other tests, and carry out the treatment under the doctor’s advice and guidance.
Nursing care
Daily care
1. Open windows regularly, keep the environment quiet and clean, and maintain appropriate temperature and humidity. 2. Arrange work and rest time reasonably, combine work and rest, and avoid overwork and high mental tension. 3. Have small and frequent meals, and avoid overeating.
Diet
Reasonable diet, small and frequent meals. Low-fat, high-vitamin, dietary fiber-rich diet, less fat-containing foods.