Sauter G, Ruckdeschel G, Sauerbruch T
Medizinische Klinik II, Klinikum Grosshadern, Ludwig-Maximilians-Universität, München.
Leber Magen Darm. 1992 Sep;22(5):173-6.
Endoscopic retrograde cholangiopancreatography (ERCP) may be complicated by bacteremia, cholangitis, or biliary sepsis. Bacteremia during ERCP implies a potential risk of endocarditis in patients with valvular prostheses or a previous history of infectious endocarditis. For these patients antibiotic prophylaxis prior to ERCP is recommended. Cholangitis or biliary sepsis may develop after ERCP in patients with obstructed bile ducts. In these patients antibiotics should be administered until adequate drainage of biliary obstructions is achieved. Antibiotic prophylaxis and antibiotic therapy must consider the spectrum of micro-organisms which is normally found in each of these situations. Regarding bacteremias associated with ERCP gram-positive cocci predominate, whereas cholangitis and biliary sepsis are caused mainly by gram-negative rods like Escherichia coli, Pseudomonas aeruginosa, or Klebsiella spp.
内镜逆行胰胆管造影术（ERCP）可能会并发菌血症、胆管炎或胆源性脓毒症。ERCP期间的菌血症意味着人工瓣膜患者或有感染性心内膜炎病史的患者存在发生心内膜炎的潜在风险。对于这些患者，建议在ERCP前进行抗生素预防。胆管梗阻患者在ERCP后可能会发生胆管炎或胆源性脓毒症。对于这些患者，应给予抗生素治疗，直至胆管梗阻得到充分引流。抗生素预防和抗生素治疗必须考虑在每种情况下通常发现的微生物谱。关于与ERCP相关的菌血症，革兰氏阳性球菌占主导，而胆管炎和胆源性脓毒症主要由革兰氏阴性杆菌引起，如大肠杆菌、铜绿假单胞菌或克雷伯菌属。
