Acute bacterial cholangitis: an analysis of clinical manifestation.

A retrospective study of 65 patients with biliary sepsis and mechanical biliary obstruction, 19 of them with suppurative cholangitis (SC) and 46 with nonsuppurative cholangitis (NSC), was undertaken to identify distinguishing characteristics of the two forms of the disease. There were no statistically significant differences between SC and NSC based on histologic data, physical findings, or preoperative laboratory values. Mortality was significantly increased in patients with SC and in those with both forms of the disease who were given medical therapy alone. The treatment of choice for cholangitis with mechanical biliary obstruction is early operative drainage of the biliary tree, regardless of the presence or absence of suppuration in the common bile duct.