Cholangitis Treatment & Management
- Author: Homayoun Shojamanesh, MD; Chief Editor: Julian Katz, MD more...
Administration of broad-spectrum intravenous antibiotics and correction of fluid and electrolyte imbalances constitute essential medical care for cholangitis.
- High biliary pressures caused by an obstruction may impair the biliary secretion of antibiotics; therefore, treatment may require decompression and drainage of the biliary system.
- For patients with severe cholangitis, endoscopic drainage has replaced emergency surgical common duct exploration and T-tube drainage as standard treatment.
- Percutaneous transhepatic biliary drainage (PTBD) is another possible nonsurgical method of biliary drainage.
Endoscopic biliary drainage and decompression have usually replaced surgery as the initial treatment of severe cholangitis. Surgical decompression is appropriate for patients in whom endoscopic or transhepatic drainage is unsuccessful or unavailable.
Following adequate biliary drainage and decompression for acute cholangitis with bacteremia, Park et al found no significant differences in the recurrence of acute cholangitis and 30-day mortality between early switch to oral antibiotic therapy and standard 10-day intravenous antibiotic therapy.
See the list below:
Patients should take nothing by mouth in the acute stage of cholangitis. Accomplish hydration with intravenous fluids.
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