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Serial cholangiographic appearances in recurrent pyogenic cholangitis
M S Khuroo1, M Y Dar, G N Yattoo
1Institute of Medical Sciences, Kashmir, India.
Gastrointestinal Endoscopy
|September 1, 1993
Summary
Recurrent pyogenic cholangitis is a progressive biliary disease. Early intervention, like endoscopic sphincterotomy, can resolve symptoms and improve cholangiographic abnormalities.
Area of Science:
- Gastroenterology
- Hepatology
- Radiology
Background:
- Recurrent pyogenic cholangitis (RPC) is a significant biliary tract disease.
- Cholangiographic findings in RPC include dilation, calculi, sludge, and strictures.
- Biliary ascariasis is implicated in some RPC cases.
Purpose of the Study:
- To evaluate the natural course of recurrent pyogenic cholangitis.
- To assess the impact of interventions on RPC outcomes.
- To identify potential initiating factors for RPC.
Main Methods:
- Retrospective analysis of 227 patients with RPC from 1982-1991.
- Cholangiography used for initial diagnosis and follow-up.
- Comparison of outcomes in conservative management, endoscopic sphincterotomy, and surgical interventions.
Main Results:
- 21 patients showed evidence of biliary ascariasis.
- Conservative management led to worsening RPC and cholangiographic abnormalities.
- Endoscopic sphincterotomy with calculus extraction resulted in symptom resolution and improved abnormalities in 25 patients.
- Failed interventions correlated with persistent RPC and worsening abnormalities.
Conclusions:
- Recurrent pyogenic cholangitis follows a progressive, destructive cholangiopathy course.
- Ascaris lumbricoides infection is an initiating factor in a subset of RPC patients.
- Successful endoscopic intervention offers a favorable prognosis for RPC.