Biliary Tract: Recurrent Pyogenic Cholangitis

Other Names

• “Cholangiohepatitis”
• “Hong Kong Disease”
• “Oriental Cholangitis”

Pathology

• Recurrent Cholangitis from Bile Stasis
  • Recurrent Infection Induces Strictures
  • Stones Form Proximal to Strictures
    • Bacteria & Parasites Deconjugate Bilirubin
    • Black & Brown Pigment Stones Form in Bile Ducts
• Almost Exclusively in Southeast Asia

Diagnosis

• Dx: MRCP or ERCP

Treatment

• Acute Cholangitis: IVF, ABX & ERCP
• Chronic Management: Surveillance vs Surgery
  • Surveillance – Regular with Frequent Stone Clearance (ERCP/PTC)
  • Surgery – Affected Hepatic Resection with Hepaticojejunostomy