Recurrent Pyogenic Cholangitis

Wong, John; Choi, T. K.

doi:10.1159/000171744

Cited by 15 publications

(5 citation statements)

References 40 publications

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“…Overall good results after treatment of PIHL were 58.3%, 77.0%, 84.0%, 65.0%, and 73.4% in the series of Chen et al, Tsunoda et al, Di Carlo et al and Wong and our own, respectively [8, 15, 22, 31]. The best results are achieved in patients with localized disease treated by hepatic resection.…”

Section: Discussionmentioning

confidence: 54%

Non‐Oriental Primary Intrahepatic Lithiasis: Experience with 48 Cases

et al. 2005

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Abstract. An experience with the diagnosis and treatment of patients with non-Oriental primary intrahepatic lithiasis (PIHL) is described. A group of 48 native Brazilian patients with symptomatic PIHL were studied, and the patientsÕ characteristics, diagnoses, treatment protocols based on the presentation of the disease, prognostic factors, and late results were analyzed. Liver resection was performed in patients with an irreversible lesion, such as parenchymal atrophy or biliary stenosis; and biliary drainage procedures were employed in patients with bilateral disease. Late results were considered good when no postoperative symptoms were observed and poor if there was pain recurrence or cholangitis. Overall good results were observed in 73.4% of the patients. Good late results were observed in 94.1% and 62.1% of the patients with unilateral and bilateral stones, respectively. None of the analyzed parameters (gender, age, previous biliary surgery, bilirubin level, serum leukocyte counts, prothrombin activity, previous history of cholangitis, stone location) predicted poor late results, but the risk for patients with bilateral stones to develop late complications was 7.2 times higher than for those with unilateral disease.Non-Oriental PIHL is a rare disease, and the patientsÕ characteristics are similar to those of patients with Oriental PIHL. We believe that personalized treatment based on the presentation of the disease led to the high incidence of good late results in this series.

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Section: Discussionmentioning

confidence: 54%

Non‐Oriental Primary Intrahepatic Lithiasis: Experience with 48 Cases

et al. 2005

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“…Particularly severe cases of RPC can present as Reynold's pentad, the constellation of altered mental status, fever, jaundice, right upper quadrant pain, and hypotension. Elderly patients with RPC may present atypically, with general clinical deterioration in the absence of pain and fever ( 12 , 25 ).…”

Section: Diagnosismentioning

confidence: 99%

The role of endoscopy in the management of recurrent pyogenic cholangitis: a review

Metwally

Man

2015

Journal of Community Hospital Internal Medicine Perspectives

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Recurrent pyogenic cholangitis (RPC) is a clinical syndrome characterized by repeated episodes of suppurative cholangitis due to hepatolithiasis and extrahepatic stones in the biliary ducts. It is now recognized as a distinct syndrome with a different natural history and pathoetiology than spontaneously occurring liver abscesses. Most commonly seen in East Asian populations, this syndrome is growing increasingly common in Western Nations due to migration patterns. The exact pathogenesis of RPC remains elusive; although colonization of the biliary tract with particular enteric bacterial species, in combination with possible dietary factors, has been attributed as causative factors. Hepatobiliary surgery, in particular segmental hepatectomy, is often described as the definitive treatment of choice for RPC. The exact role of endoscopic intervention has been less clearly described in the literature. This review focuses on the management of RPC while highlighting situations in which endoscopic retrograde cholangiopancreatography may be preferred over surgery as an initial or salvage therapeutic measure.

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“…Practically ail patients with intrahepatic stones present with cholangitis [1,4,9]. The triad of symptoms--fever, jaundice, and right upper quadrant pain--is present in 60% of the cases.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…The pathology of intrahepatic stones has been well described [4,6]. Stones occur most commonly in both hepatic ducts.…”

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confidence: 99%

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Current management of intrahepatic stones

Choi

Wong

1990

World j. surg.

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A high incidence of intrahepatic stones occurs in East Asia. The surgical management of intrahepatic stones is problematic because it is difficult to locate and remove all the stones and relieve the accompanying biliary strictures. Consequently, the rate of recurrent cholangitis is high. Many new techniques have been introduced to locate, fragment, and retrieve gallstones. Operative procedures to relieve biliary strictures have also undergone development. These new procedures and techniques have been applied to intrahepatic stones. The initial results are good. Whether these good results can be maintained in the long-term remains to be seen.

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Recurrent Pyogenic Cholangitis

Cited by 15 publications

References 40 publications

Non‐Oriental Primary Intrahepatic Lithiasis: Experience with 48 Cases

Non‐Oriental Primary Intrahepatic Lithiasis: Experience with 48 Cases

The role of endoscopy in the management of recurrent pyogenic cholangitis: a review

Current management of intrahepatic stones

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