The significance of intrabiliary pressure in acute cholangitis.

To assess the relation of intrabiliary pressure to the incidence of bacteremia in instances of acute cholangitis, 20 patients were prospectively studied herein. They were divided into two groups: patients (n equals ten) with an intrabiliary pressure of more than 25 cubic centimeters of H2O were in group 1, and patients (n equals ten) with an intrabiliary pressure of less than 25 cubic centimeters of H2O were in group 2. All patients underwent operation. Bacteremia occurred in a proportion of 60 per cent during admission and increased to 90 per cent after a short interval of time in patients in group 1. In group 2, bacteremia was 20 per cent at admission and increased to 40 per cent after the same interval of time. Mortality was 30 per cent in patients in group 1 and 10 per cent for those in group 2. Data of this study suggest that the urgent release of obstruction of the biliary tract, either endoscopically or surgically, is important in order to minimize biliary pressure and subsequently reduce the incidence of bacteremia and improve survival time for patients undergoing treatment due to acute cholangitis.