Articles producció científica> Medicina i Cirurgia

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

  • Datos identificativos

    Identificador: imarina:9326296
    Autores:
    Nve, EBadia, JMAmillo-Zaragueeta, MJuvany, MMourelo-Fariña, MJorba, R
    Resumen:
    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.
  • Otros:

    Autor según el artículo: Nve, E; Badia, JM; Amillo-Zaragueeta, M; Juvany, M; Mourelo-Fariña, M; Jorba, R
    Departamento: Medicina i Cirurgia
    Autor/es de la URV: Jorba Martin, Rosa Maria
    Palabras clave: 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
    Resumen: 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.
    Áreas temáticas: Medicine, general & internal Medicine (miscellaneous) Medicine (all)
    Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
    Direcció de correo del autor: rosamaria.jorba@urv.cat
    Identificador del autor: 0000-0003-3307-4340
    Fecha de alta del registro: 2024-08-03
    Versión del articulo depositado: info:eu-repo/semantics/publishedVersion
    Enlace a la fuente original: https://www.mdpi.com/2077-0383/12/14/4711
    URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referencia al articulo segun fuente origial: Journal Of Clinical Medicine. 12 (14): 4711-
    Referencia de l'ítem segons les normes 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
    DOI del artículo: 10.3390/jcm12144711
    Entidad: Universitat Rovira i Virgili
    Año de publicación de la revista: 2023
    Tipo de publicación: Journal Publications
  • Palabras clave:

    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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