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