BACKGROUND/AIMS: It is very important for physicians to evaluate the severity of the biliary infection. At the moment, there is no useful quantitative system. In this study, we propose a scoring system for assessing the severity of biliary infections and evaluation of the efficacy of antibacterial and endoscopic treatments. MATERIALS AND METHODS: We created a biliary tract infection score (BTIS) including local physical and ultrasound findings, signs of inflammation and hepatobiliary involvement. The BTIS was calculated in 317 patients: group I-155 pts with cholecystitis and cholangitis, treated only by antibiotics and group II-162 pts with acute cholangitis treated by endoscopic procedures. RESULTS: The BTIS allowed the differentiation of the severity of biliary infections: 15.50 +/- 0.52 in acute cholangitis group and 5.77 +/- 2.79 in group I (p < 0.001). The BTIS significantly decreased after antibacterial therapy (excluding only the cefotiam subgroup) and in endoscopicaly treated patients. CONCLUSIONS: The BTIS is a combination of simple, reliable, acceptable and low cost parameters, reflecting the principal pathological processes and degree of abnormalities. A BTIS facilitated the assessment of severity of biliary infection and comparison of the results of various methods of treatment.
BACKGROUND/AIMS: It is very important for physicians to evaluate the severity of the biliary infection. At the moment, there is no useful quantitative system. In this study, we propose a scoring system for assessing the severity of biliary infections and evaluation of the efficacy of antibacterial and endoscopic treatments. MATERIALS AND METHODS: We created a biliary tract infection score (BTIS) including local physical and ultrasound findings, signs of inflammation and hepatobiliary involvement. The BTIS was calculated in 317 patients: group I-155 pts with cholecystitis and cholangitis, treated only by antibiotics and group II-162 pts with acute cholangitis treated by endoscopic procedures. RESULTS: The BTIS allowed the differentiation of the severity of biliary infections: 15.50 +/- 0.52 in acute cholangitis group and 5.77 +/- 2.79 in group I (p < 0.001). The BTIS significantly decreased after antibacterial therapy (excluding only the cefotiam subgroup) and in endoscopicaly treated patients. CONCLUSIONS: The BTIS is a combination of simple, reliable, acceptable and low cost parameters, reflecting the principal pathological processes and degree of abnormalities. A BTIS facilitated the assessment of severity of biliary infection and comparison of the results of various methods of treatment.
Authors: Nechol L Allen; Ruth R Leeth; Kelly R Finan; Darren S Tishler; Selwyn M Vickers; C Mel Wilcox; Mary T Hawn Journal: J Gastrointest Surg Date: 2006-02 Impact factor: 3.452