Acute cholangitis (AC) is one of the most severe and life-threatening complications of benign biliary tract diseases, the main of which is cholelithiasis (CCD). Every tenth inhabitant of the planet suffers from ACS, and choledocholithiasis (CHO), as its complication, occurs in 20-30% of cases, stenosis of the terminal common bile duct (TCD) occurs in 3-40% of patients with ACS. The number of patients with ACS increases by 2 times during each decade, which is accompanied by an increase in the frequency of its complicated forms. According to various authors, ACS is complicated by mechanical jaundice (MJ) in 13-43% of patients, and the frequency of ACS development in ACS is 66.4-88.1%, which currently represents an independent problem. To a large extent, this is due to the increase in the number of patients with complicated forms of biliary tract infections, the decrease in the effectiveness of antibacterial drugs in the treatment of purulent diseases, the tendency of biliary tract infections to generalize with the formation of multiple liver abscesses, the development of biliary sepsis, and multiple organ failure. The frequency of purulent complications of inflammatory diseases of the biliary tract, despite the close attention of researchers to this problem, remains extremely relevant. The inflammatory process of this localization is characterized not only by a local purulent-destructive process, but also by systemic disorders that quickly lead to severe endogenous intoxication and severe multiorgan dysfunction.
The introduction into clinical practice of such minimally invasive interventions as ERCP, EPST, NBD, endoscopic balloon papilledilatation (EPD), endoprosthesis, methods of laparoscopic sanitation of the common bile duct and mini-access technology has opened up great opportunities for clinicians in the diagnosis and treatment of complicated forms of CHD. Minimally invasive methods of decompression of the bile ducts in acute cholangitis are the most appropriate, since they are accompanied by fewer complications and lower mortality. However, there are certain difficulties for the widespread use of minimally invasive methods, associated with their technical complexity and the presence of numerous contraindications to their use. At the same time, there is no consensus on the timing of radical surgical interventions after the first stage of minimally invasive operations aimed at decompression and relief of the phenomena of MH and GC. These terms vary from 2 to 30 days or more. Thus, determining the relationship between cholangitis, as a pathomorphological process in VL, and various forms of septic reactions and the issue of complex treatment of GC remain relevant for modern medical science and require further research.
