Acute Biliary Septic Shock

摘要

Forty-seven cases of biliary tract infection with septic shock are presented. The sepsis was caused byempyema of the gallbladder in 23 cases and by cholangitis in the remainder. Gallstones were mostfrequently the cause of the sepsis. An appropriate diagnostic description of the syndrome of biliary tractinfection and septic shock should therefore include a description of the underlying biliary disease as wellas the term acute biliary shock. In this series, emergency surgical management by removal of gallstonesand drainage of suppuration was felt to be the most appropriate treatment. There was a high incidenceof gallbladder rupture (10.6%) and intrahepatic stones (53.2%). Of the 13 patients who died, 8 mighthave survived if early operation had been performed after the diagnosis of acute biliary septic shock wasestablished.