Reasonable options and controversies of laparoscopic treatment for acute cholangitis
ZHAO Hai-ying
LIU Jin-gang
Abstract：Treatment option of acute cholangitis is closely related to diagnosis and severity assessment. For moderate and severe acute cholangitis,early biliary drainage should be performed. Both of China and aboard guidelines recommend endoscopic naso-biliary drainage(ENBD)as the first choice, and suggest that percutaneous transhepatic cholangial drainage(PTCD)and surgical operation may be considered as alternative methods. With the current technology and accurate severity assessment in acute cholangitis, emergency laparoscopic common bile duct exploration (LCBDE) can be performed safely and effectively for patients with mild and moderate acute cholangitis caused by common bile duct stones. For mild acute cholangitis, emergency LCBDE operation is the same as elective operation. For moderate acute cholangitis,massive bleeding and difficult suture due to thin or thick biliary wall may occur, which need special management even conversion to open operation when necessary. Surgical biliary drainage should be avoided in severe cholangitis. When ENBD and PTCD failed, or contraindications occurred,open surgical biliary drainage should be performed.
Keywords：laparoscopyacute cholangitiscommon bile duct stoneslaparoscopic common bile duct exploration(LCBDE)endoscopic naso-biliary drainage(ENBD)
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 486-490 )