Surgical management of recurrent pyogenic cholangitis: 10 years of experience in a tertiary referral centre in Hong Kong

Abstract

Recurrent pyogenic cholangitis is a distinct disease, the management of which requires a high level of surgical expertise. Hepaticojejunostomy is recommended as the primary drainage procedure, but hepatectomy should be reserved for complicated RPC.

Outcome of surgery for recurrent pyogenic cholangitis: a single center experience

“…Overall postoperative complications are more common in patients with RPC. In recently published series, it varied from 17% to 45% 6,24,25 and half of the complications were wound infections. Similarly in the present study, postoperative complications developed in 29% of patients and the most common complication was wound infection.…”

Recurrent Pyogenic Cholangitis: Got Stones?

“…Although rarely used anymore, repeat access to the biliary system was previously performed through the creation of a hepatico-cutaneo-jejunostomy, by which a choledochoscope could be used to explore the intrahepatic ducts for stone clearance. In place of this cutaneous stoma, a T-tube can be inserted in the Roux limb of the hepatico-jejunostomy or into the biliary tract to facilitate stone removal and ensure patency of the ductal system postoperatively, if needed [11,13].…”

Benign Tumours and Pseudotumours Within the Porta Hepatis Masquerading as Perihilar Cholangiocarcinoma

“…Plann ing treatment of RPC complicated with HC requires careful judgement, tak ing into consideration both dis ease processes. The type of surgical operation should be guided on one hand by the HC clinical stage and on the other by the location of intrahepatic stones, the present of additional biliary strictures and coexistent parenchymal liver atrophy [153].…”