目的探讨急性梗阻性化脓性胆管炎（ＡＯＳＣ）的早期诊断及４种胆道非手术减压法的疗效。方法ＡＯＳＣ２６例，其中原发病为胆总管结石１７例，胆道、胰腺肿瘤９例。采用ＥＳＴ治疗１１例，ＮＢＤ６例，ＥＢＤ４例以及ＰＴＣＤ５例；胆汁行显微镜检查与细菌培养。结果胆汁细菌培养２６例皆为革兰氏阴性菌属，２４例（９２３％）治疗有效，２例（７７％）死亡。结论胆道非手术减压法治疗ＡＯＳＣ能迅速有效地改善临床症状，降低急诊手术死亡率。 Objective To investigate the early diagnosis of acute obstructive suppurative cholangitis (AOSC) and the efficacy of four biliary non-surgical decompression methods. Methods AOSC 26 cases, of which the primary disease was common bile duct stones in 17 cases, 9 cases of biliary tract and pancreatic tumors. 11 cases were treated with EST, 6 cases of NBD, 4 cases of EBD and 5 cases of PTCD; bile line microscopy and bacterial culture. Results Twenty-six cases of bile bacteria were Gram-negative bacteria, 24 cases (923%) were treated effectively and 2 cases (77%) died. Conclusion Non-surgical treatment of AOSC with biliary non-surgical decompression can quickly and effectively improve the clinical symptoms and reduce the emergency operation mortality rate.