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Related Experiment Videos

Postoperative biliary ascariasis: presentation and management--experience.

N A Wani1, O J Shah, S H Naqash

  • 1Department of General Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.

World Journal of Surgery
|October 19, 2000
PubMed
Summary

Common bile duct exploration for worms is uncommon. T-tube irrigation with saline effectively expelled worms in most patients, avoiding repeat surgery.

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Area of Science:

  • Gastroenterology
  • Hepatobiliary Surgery
  • Parasitology

Background:

  • The common bile duct (CBD) is occasionally explored due to preoperative or perioperative indications.
  • Parasitic infections, such as ascariasis, can affect the biliary system, necessitating intervention.
  • T-tube placement is a common surgical practice following CBD exploration.

Purpose of the Study:

  • To evaluate the incidence of worms in the common bile duct following surgical exploration.
  • To assess the efficacy of T-tube irrigation with normal saline for worm expulsion.
  • To determine the need for reoperation in cases of biliary ascariasis.

Main Methods:

  • A retrospective review of 705 patients who underwent CBD exploration between January 1983 and December 1994.

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  • Postoperative T-tube cholangiography was performed to identify retained stones or parasites.
  • T-tube irrigation with 0.9% normal saline was employed for patients with detected worms.

    • Main Results:

    • Worms were identified in the CBD via T-tube cholangiography in 22 out of 705 patients (3.1%).
    • T-tube irrigation successfully facilitated worm expulsion in 18 of these 22 patients.
    • Only one patient required re-exploration for worm removal; others were managed non-operatively or with T-tube removal.

    Conclusions:

    • Biliary ascariasis, while uncommon, can be encountered during CBD exploration.
    • T-tube irrigation with normal saline is a safe and effective method for expelling worms from the CBD.
    • Conservative management, including T-tube irrigation, often obviates the need for repeat surgical intervention.