Laproscopic management of wandering biliary ascariasis

Area of Science:

• Hepatobiliary Medicine
• Infectious Diseases
• Gastroenterology

Background:

• Ascariasis is a prevalent helminthic infection, particularly in developing nations with suboptimal public health.
• Biliary ascariasis, though uncommon, can lead to significant complications like obstructive jaundice.
• Endoscopic worm extraction is the standard treatment for biliary ascariasis.

Purpose of the Study:

• To report a rare case of extrahepatic biliary obstruction caused by Ascaris.
• To highlight an alternative surgical approach for managing biliary ascariasis.
• To present the successful laparoscopic management of a complex case.

Main Methods:

• A case report of a young male presenting with acute cholangitis due to biliary obstruction.
• Diagnostic workup including imaging to identify the cause of obstruction.
• Surgical intervention involving laparoscopic exploration and common bile duct exploration for worm removal.

Main Results:

• Ascaris-induced extrahepatic biliary obstruction was diagnosed.
• Successful removal of the Ascaris worm via laparoscopic common bile duct exploration.
• The patient experienced an uneventful postoperative recovery.

Conclusions:

• Laparoscopic exploration of the common bile duct is a viable and effective treatment for biliary ascariasis causing obstruction.
• This approach offers a minimally invasive option for managing rare cases of helminthic biliary obstruction.
• Prompt surgical intervention can lead to favorable outcomes in patients with acute cholangitis secondary to ascariasis.