Articles producció científica> Medicina i Cirurgia

Early Management of Severe Biliary Infection in the Era of the Tokyo Guidelines

  • Identification data

    Identifier: imarina:9326296
  • Authors:

    Nve, E
    Badia, JM
    Amillo-Zaragueeta, M
    Juvany, M
    Mourelo-Fariña, M
    Jorba, R
  • Others:

    Author, as appears in the article.: Nve, E; Badia, JM; Amillo-Zaragueeta, M; Juvany, M; Mourelo-Fariña, M; Jorba, R
    Department: Medicina i Cirurgia
    URV's Author/s: Jorba Martin, Rosa Maria
    Keywords: Surgery Severe sepsis Review International consensus definitions Inflammatory response syndrome Gangrenous cholecystitis Gallbladder Endoscopic ultrasound Common bile-duct Biliary infection Antimicrobial therapy Antibiotic treatment Acute cholecystitis Acute cholangitis Acute calculous cholecystitis Acalculous cholecystitis 2018 diagnostic-criteria
    Abstract: Sepsis of biliary origin is increasing worldwide and has become one of the leading causes of emergency department admissions. The presence of multi-resistant bacteria (MRB) is increasing, and mortality rates may reach 20%. This review focuses on the changes induced by the Tokyo guidelines and new concepts related to the early treatment of severe biliary disease. If cholecystitis or cholangitis is suspected, ultrasound is the imaging test of choice. Appropriate empirical antibiotic treatment should be initiated promptly, and selection should be performed while bearing in mind the severity and risk factors for MRB. In acute cholecystitis, laparoscopic cholecystectomy is the main therapeutic intervention. In patients not suitable for surgery, percutaneous cholecystostomy is a valid alternative for controlling the infection. Treatment of severe acute cholangitis is based on endoscopic or transhepatic bile duct drainage and antibiotic therapy. Endoscopic ultrasound and other new endoscopic techniques have been added to the arsenal as novel alternatives in high-risk patients. However, biliary infections remain serious conditions that can lead to sepsis and death. The introduction of internationally accepted guidelines, based on clinical presentation, laboratory tests, and imaging, provides a framework for their rapid diagnosis and treatment. Prompt assessment of patient severity, timely initiation of antimicrobials, and early control of the source of infection are essential to reduce morbidity and mortality rates.
    Thematic Areas: Medicine, general & internal Medicine (miscellaneous) Medicine (all)
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: rosamaria.jorba@urv.cat
    Author identifier: 0000-0003-3307-4340
    Record's date: 2024-01-14
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://www.mdpi.com/2077-0383/12/14/4711
    Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Journal Of Clinical Medicine. 12 (14): 4711-
    APA: Nve, E; Badia, JM; Amillo-Zaragueeta, M; Juvany, M; Mourelo-Fariña, M; Jorba, R (2023). Early Management of Severe Biliary Infection in the Era of the Tokyo Guidelines. Journal Of Clinical Medicine, 12(14), 4711-. DOI: 10.3390/jcm12144711
    Article's DOI: 10.3390/jcm12144711
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2023
    Publication Type: Journal Publications
  • Keywords:

    Medicine (Miscellaneous),Medicine, General & Internal
    Surgery
    Severe sepsis
    Review
    International consensus definitions
    Inflammatory response syndrome
    Gangrenous cholecystitis
    Gallbladder
    Endoscopic ultrasound
    Common bile-duct
    Biliary infection
    Antimicrobial therapy
    Antibiotic treatment
    Acute cholecystitis
    Acute cholangitis
    Acute calculous cholecystitis
    Acalculous cholecystitis
    2018 diagnostic-criteria
    Medicine, general & internal
    Medicine (miscellaneous)
    Medicine (all)
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