The principal indications for sphincterotomy include removal of common bile duct stones, treatment of papillary stenosis, and facilitation of endotherapy (ie, stent placement, tissue sampling, and stricture dilation) Altered sensorium, hypotension and renal failure can often be seen in patients with suppurative cholangitis. In many cases, bile duct infection is latent and does not cause symptoms. Cholangitis varies in severity from a mild form which responds to parenteral antibiotics alone to severe or suppurative cholangitis which requires early drainage of biliary system to reduce the incidence of systemic complications.
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