Abstract
Acute suppurative cholangitis continues to be fatal in cases of choledocholithiasis and in biliary tract malignancy. ERCP and ERS allows early detection and treatment of suppurative cholangitis and prevents its progression to multiple organ failure. We carried out ERCP in 8,146 cases in which 90 cases were diagnosed as acute cholangitis. The average age of patients was 68.1 years, most of them between 6 th and 8 th decade. The sex distribution was equal. Causes of ASC were as follows; choledocholithiasis in 68 cases (75.6%), malignancy of biliary tract in 18 cases (20.0%), miscellaneous in 4 cases (4,4%).
The emergency ES and removal of CBD stone was performed soon after confirmation of ASC. Satisfactory biliary drainage was obtained in 37.8% and stone extraction in 62.2%. The mortality rate was 3.3% (3/90) which suggested that endoscopic approach was better than conventional approaches reported earlier. The three patients who died had severe form of DIC. Early ERCP and ERS would prevent such complications.
