CHOLANGITIS IN RESIDUAL CHOLEDOCHOLITHIASIS
The acute cholangitis development rules in residual choledocholithiasis were studied. The task was set to identify dependence of acute cholangitis expression on bile ducts pathological lesions degree in residual choledocho-lithiasis. 23 patients with residual choledocholithiasis, 6 (26,1%) men and 18 (73,9%) women aged 37 to 69. 8 (34,8%) patients delivered to the hospital had external drainage of choledoch. Diagnostic program included clinical laboratory methods of investigation, ultrasound scanning, fistulocholangiography and retrograde cholangiography, endoscopic investigation of the upper portion of gastro-intestinal tract with Vater’s papilla visualization, bacteriological examination of bile, histological investigation, choledochomanometry. In all cases of residual choledocholithiasis there were revealed evidence of acute cholangitis, in 14 (60,9%) cases – fibrinous cholangitis, acute purulent cholangitis – in 9 (39,1%) cases. The bacteriological investigation of bile revealed colon bacillus, Proteus, Klebsiella, enterococcus, anaerobes non-sporeformers. Thus, residual choledocholithiasis was attended by acute cholangitis of various degree of manifestation. It should be considered in planning of treatment program for patients with residual choledocholithiasis.
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