Gall bladder decompression for cholangitis: bridge to a definitive procedure

Abstract

Introduction and Aim: Cholangitis requires

obstruction of the biliary tree with superadded infection of

the biliary system. Obstruction could be due to stone

disease, stricture in the bile duct and growth involving the

biliary system. Apart from the medical resuscitation,

immediate decompression of the biliary system is also

needed in patients with severe cholangitis. We present our

experience with emergency biliary decompression through

the gall bladder. Materials and methods: We analysed

our case records retrospectively from Jan 2014 to May

2017, and identified three patients who underwent

emergency gall bladder decompression for cholangitis and

analysed their clinical presentation, response to treatment

and clinical outcome. Results: All three patients had grade

III cholangitis with varied etiologies. The reasons for

performing gallbladder decompression was because of

severe cholangitis and failed endotherapy or unavailability

of percutaneous/ ERCP guided therapy in the emergency

setting. All the patients underwent Ultrasound guided

percutaneous catheter drainage under local anaesthesia.

Outcome of these patients depends upon the primary

pathology, co-morbidity, performance status. Conclusion:

When endoscopic or percutaneous techniques are either

unavailable or have failed, Gall baldder decompression

can achieve successful biliary decompression and should

be kept in mind to salvage the patient in difficult situations.