Oriental cholangiohepatitis: diagnostic imaging and interventional management

The role of ERCP in choledocholithiasis

“…Whatever the reasons are, a majority of patients who were referred to our center with this condition had been given incorrect diagnoses or had ERCP that missed the key findings. Finally, the uninitiated gastroenterologists, radiologists or surgeons may be quick to perform procedures that are routine for common choledocholithiasis stone disease but could lead to serious complications in RPC (Table 4) [41,152,[154][155][156][157][158][159].…”

“…US has been shown to detect some, although incomplete, features of RPC in all patients [157,[160][161][162]. CT offers better diagnostic details, especially on intrahepatic findings such as hepaticolithiasis, segmental atrophy and liver abscess [163].…”

Percutaneous removal of residual intrahepatic stones through transjejunal T-tube tract

“…But in cases of recurrent pyogenic cholangiohepa titis , the extraction of residual intrahepatic stones through conventional T-tube choledochostomy tract is troblesom e due to multifocal intrahep atic biliary strictures , multiplicity of stones , impacted stones , and the large size of stones. Thus , repeated inte rventional procedures with complex techniques such as dilatation of strictures a nd crushing of stones a re mandatory (4)(5)(6) W e required the surgeon to place a T -tu be at j ejunal site for removal of residual biliary stones in ten patients with choledochojejunostomy. In all cases , T-tube was inserted into jejunum , and its uppe r limb was placed within the CBD through the anastomotic site.…”

Biliary ascariasis in the etiology of recurrent pyogenic cholangitis in an endemic area

“…In India (Kashmir), RPC constitutes 12.5% of all patients with biliary disease [10]. This unusual biliary tract syndrome is now being encountered with increased frequency in Western societies especially in the United States, largely as a result of increased immigration of refugees from Asia during and after the Vietnam War [11][12][13].…”