[Suppurated acute obstructive cholangitis. Anatomoclinical and therapeutic aspects].

A total of 134 cases are discussed, with suppurated acute obstructive angiocholitis, that underwent surgical treatment over a period of 10 years, representing 12,8% of the total number of organic obstructions of the hepato-choledocus. From the standpoint of the etiopathogenic mechanisms the angiocholitis was determined by biliary lithiasis in 59 cases, by sclerosis of the Oddi sphincter in 5 cases, by postoperative cicatriceal stenosis of the main biliary pathway in 2 cases, by hepatic hydatitosis in 16 cases, by Vater ampuloma in 10 cases by cancers of the main biliary pathway in 40 cases and by the congenital cyst of the choledocus in one case. The high frequency was noted, of the severe forms of ictero-uremigenic angiocholitis (representing 68 cases, or 50,7% of the total, with a death rate of 34%). Medico-surgical treatment should be performed as early as possible, and it must be intensive, complex, and adapted to the anatomo-clinical forms. The authors performed evacuation choledocotomy with external draining in 22 cases (3 deaths), and choledoco-duodenal anastomosis in 46 cases (10 deaths), choledoco-jejunostomia in 3 cases, Oddi sphincterotomia in 12 cases (2 deaths) ampulectomia in 5 cases (2 deaths). Peripheral bilio-hepatodigestive anastomoses were performed in 40 cases with 5 deaths.