Management of Cholangitis
Patient Guideline Summary
- Cholangitis is an infection of the gallbladder due to an obstructed duct, usually by a gallstone. It is a life-threatening emergency.
- Symptoms include jaundice (yellow coloring of the skin and the white part of the eyes), fever, and pain under the right ribs.
- This patient summary focuses on the endoscopic management of cholecystitis.
- Antibiotics are standard medical care, but the surgical opening of the obstructed duct is usually required.
- ASGE prefers endoscopic retrograde cholangiopancreatography (ERCP) over percutaneous transhepatic biliary drainage (PTBD).
- ERCP should be done within 48 hours of diagnosis.
- ASGE suggests that biliary drainage be combined with other maneuvers such as sphincterotomy and stone removal versus stent placement without attempted stone removal.
*ERCP describes inserting a long, flexible instrument through the mouth and into the upper part of the intestine. The instrument combines surgical tools with a scope.
*PTBD describes a similar procedure done through the skin and liver.
*Sphincterotomy describes an incision through the valve that connects the bile and pancreatic duct with the intestine to allow passage of the obstructing stone.
*A stent is a tube placed in a duct (or artery) that keeps it open.
- ASGE: American Society For Gastrointestinal Endoscopy
- ERCP: Endoscopic Retrograde Cholangiopancreatography
- PTBD: Percutaneous Transhepatic Biliary Drainage