关键词: 急性梗阻性化脓性胆管炎, 内镜逆行胰胆管造影术, 病原菌分布, 治疗

Abstract: Objective The purpose of this study was to investigate the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of patients with acute obstructive suppurative cholangitis (AOSC). Methods A total of 106 patients with AOSC were encountered in our hospital between March 2021 and September 2024, and were randomly assigned to receive ERCP in 55 cases in observation or receive open surgery in another 51 cases in the control. Bile pathogens were separated and characterized routinely. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were detected by ELISA. Serum C-reactive protein (CRP) and endotoxin levels were routinely obtained, and pain was assessed by visual analogue score. Results Intraoperative bleeding, operation time, VAS scores 6 hours after surgery and hospital stay in the observation were(35.4±7.5)ml, (68.5±7.0)min, (3.2±0.8) and (6.5±1.5)d, all much less or lower than [(75.0±14.0)ml, (104.0±12.5)min, (4.5±1.1) and (12.2±2.2)d, respectively, P<0.05] in the control; after operation, serum IL-6, TNF-α, CRP and endotoxin levels in the observation were (75.6±9.4)ng/L, (16.1±3.7)ng/L, (17.7±1.3)mg/L and (14.1±2.0)pg/mL, all significantly lower than [(94.1±10.2)ng/L, (22.2±4.3)ng/L, (25.7±1.7)mg/L and (21.0±3.0)pg/mL, respectively, P<0.05] in the control group; bacterial culture of bile was positive in 66 cases (62.3%), yielding 81 pathogenic strains, including Gram-positive in 29 strains (35.8%) and Gram-negative bacteria in 52 strains (64.2%), and Staphylococcus aureus accounted for 19.7% and Escherichia coli for 39.5%. Conclusion The common infected pathogens in patients with AOSC are E. coli and S. aureus, and the ERCP offers a satisfactory clinical efficacy.

Key words: Acute obstructive suppurative cholangitis, Endoscopic retrograde cholangiopancreatography, Pathogen distribution, Therapy