关键词: 急性梗阻性化脓性胆管炎, 经内镜下逆行胰胆管造影术, 胆道感染, 病原菌

Abstract: Objective The aim of this study was to investigate the efficacyof endoscopic retrograde cholangiopancreatography （ERCP） in treatment of patients with acute obstructive suppurative cholangitis （AOSC）. Methods 160 patients with AOSC were enrolled in our hospital between November 2016 and November 2018,and undergone ERCP. The patients' bile was extracted for bacterial culture and drug sensitivity measurement. The sensitivity of bacteria to various antimicrobial agents was detected by paper diffusion method. Results Out of 160 patients with AOSC,the success rate of general intubation was 92.5%;total serum bilirubin level was（60.2±43.3） μmol/L 3 days after effective drainage,which was significantly lower than [（110.1±53.0） μmol/L,P<0.05] before operation,and the percentage of neutrophils was（60.2±5.6） %,significantly lower than[（78.4±12.4）%,P<0.05] before operation;the clinical symptoms were not obviously alleviated in 13 patients and all of them cured after re-endoscopy or drug treatment and interventional therapy;no death,perforation,bleeding and other complications occurred;among 148 patients completing the surgical treatment,the positive rate of bile culture was 66.2%,130 strains of pathogenic bacteria were detected and the gram-negative bacilli faecalis,accounted for 66.2% and gram-positive cocci accounted for 33.8%;Enterococcus faecalis,Klebsiella pneumoniae and Pseudomonas aeruginosa were the main ones,among which Escherichia coli accounted for 33.1%;except for Gram-positive cocci were 100.0% sensitive to vancomycin and imipenem and Gram-negative bacilli were 100.0% sensitive to imipenem,the other bacteria showed different degrees of resistance to antibiotics. Conclusion ERCP is effective in dealing with patients with AOSC,and the appropriate administration of antibiotics base on the results of bile culture might improveefficacy and prevent drug resistance in clinical practice.

Key words: Acute obstructive suppurative cholangitis, Endoscopic retrograde cholangio-pancreatography, Biliary tract infection, Bacteria