title: What are the risk factors for acute suppurative cholangitis caused by common bile duct stones?
abstract: OBJECTIVE
  Acute suppurative cholangitis (ASC), a severe form of acute cholangitis, is a life-threatening condition that must be treated with appropriate and timely management. The purpose of this study was to identify the factors that predispose patients to ASC.
  
  
  METHODS
  We retrospectively investigated 181 patients (100 men, 81 women; age, 70.66±7.38 years, mean±SD) who were admitted to Wonkwang University Hospital between January 2005 and June 2007 for acute cholangitis with common bile duct (CBD) stones. All patients underwent endoscopic retrograde cholangiopancreatogram to remove the stones. Variables and factors that could be assessed upon admission were analyzed to identify the risk factors for the development of ASC.
  
  
  RESULTS
  Of the 181 patients, 44 (24.3%) presented with ASC. On multivariate analysis, the followings were found to be independent risk factors for the development of ASC: impacted common bile duct stone (p=0.010), current smoker status (p=0.008), advanced age (>70 years; p=0.002), and gallstone (p=0.016). The most commonly isolated organisms in bile culture were Enterococcus species, Escherichia coli, and Klebsiella species.
  
  
  CONCLUSIONS
  Impacted bile-duct stones, current smoking, advanced age, and gallstones were identified as independent risk factors for the development of ASC in patients with CBD stones. These results suggest that emergency biliary drainage is beneficial in patients with these risk factors.
authors.affiliation: Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Dong Han
authors.initials: DH
authors.lastname: Yeom
authors.forename: Hyo Jeong
authors.initials: HJ
authors.lastname: Oh
authors.forename: Young Woo
authors.initials: YW
authors.lastname: Son
authors.forename: Tae Hyeon
authors.initials: TH
authors.lastname: Kim