Quantitative assessment of severity of biliary tract infection.
OBJECTIVE
It is very important for physicians to evaluate the severity of the biliary infection. At the moment, there is no useful quantitative system. In this study, we propose a scoring system for assessing the severity of biliary infections and evaluation of the efficacy of antibacterial and endoscopic treatments.


METHODS
We created a biliary tract infection score (BTIS) including local physical and ultrasound findings, signs of inflammation and hepatobiliary involvement. The BTIS was calculated in 317 patients: group I-155 pts with cholecystitis and cholangitis, treated only by antibiotics and group II-162 pts with acute cholangitis treated by endoscopic procedures.


RESULTS
The BTIS allowed the differentiation of the severity of biliary infections: 15.50 +/- 0.52 in acute cholangitis group and 5.77 +/- 2.79 in group I (p < 0.001). The BTIS significantly decreased after antibacterial therapy (excluding only the cefotiam subgroup) and in endoscopicaly treated patients.


CONCLUSIONS
The BTIS is a combination of simple, reliable, acceptable and low cost parameters, reflecting the principal pathological processes and degree of abnormalities. A BTIS facilitated the assessment of severity of biliary infection and comparison of the results of various methods of treatment.
Krastev
Z
Z
Clinic of Gastroenterology, St.I. Rilski University Hospital, Sofia, Bulgaria.
Vladimirov
B
B
Mateva
L
L
Alexiev
A
A
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002761:Cholangitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D002764:Cholecystitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016717:Sphincterotomy, Endoscopic
D000900:Anti-Bacterial Agents