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Master Thesis

Caractéristiques des angiocholites associées au cancer

Abstract : Cancer are a frequent aetiology of acute cholangitis (AC). Our aim was to characterize AC associated with cancer (AAC) compared to AC not associated with cancer (ANAC). We retrospectively collected all cases of AC hospitalized in Beaujon Hospital between November 2015 and March 2017. AC were defined by the hospital code “Angiocholites” and fulfilled the Tokyo Guidelines diagnostic criteria. AAC were defined as AC in patients with a cancer history, responsible for AC, other cases were ANAC. 156 episodes in 130 patients were analysed: 101 AAC and 55 ANAC. Most frequent cancer were pancreatic (41.5%) and biliary tract (32.7%) cancers. Clinical presentation was similar, but cholestasis and CRP were higher in AAC. E. coli and Klebsiella spp. were the more frequent pathogens in blood but E. coli was less common in AAC (53.7% vs 72.4% p=0.004) due to higher frequency of group III enterobacteria (11/54 vs 1/48; p=0.005). For AAC, biliary drainage required more often 2 sessions (28.7% vs 8.3%, p<0.0001). Empirical antibiotherapy was not adapted in 37.3% of AC vs 15.6% of ANAC (OR: 3.18, p=0.035), history of AC being a risk factor in univariate analysis (OR 3.28, p=0.024). Outcomes on day 28 were favorable in 51.5% of cases in AAC vs 85.5% of ANAC (p<0.0001). Despite similar clinical presentations, management and prognosis of AAC is different from ANAC. The empirical antibiotherapy should be adapted to these findings, especially the frequent presence of enterococci and group 3 Enterobacteriales.
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Master Thesis
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Submitted on : Tuesday, November 30, 2021 - 6:18:24 PM
Last modification on : Thursday, January 6, 2022 - 3:08:41 AM
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  • HAL Id : dumas-03457959, version 1


Aurélien Sokal. Caractéristiques des angiocholites associées au cancer. Médecine humaine et pathologie. 2019. ⟨dumas-03457959⟩



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