RECURRENT PYOGENIC CHOLANGITIS

BACKGROUND: Recurrent pyogenic cholangitis is a complex biliary tract disease characterized by intrahepatic pigment stones, endemic to South east Asia and seen with increasing frequency in the United States. The purpose of this study was to review the management of this disorder i n a county hospital. METHODS: A retrospective review of 45 patients wi th recurrent pyogenic cholangitis evaluated between 1984 and 1995. The clinical and surgical management of patients with localized versus bi lateral hepatolithiasis were compared. RESULTS: The prevalence of recu rrent pyogenic cholangitis at our hospital has more than doubled since 1983. Fourteen of 45 patients (31%) had bilateral disease and require d more abdominal computed tomography scans (P <0.01), percutaneous cho langiograms (P <0.05), endoscopies (P <0.01), clinic visits (P <0.05), and hospital admissions (P <0.02) as compared with patients with loca lized disease. CONCLUSIONS: The effective treatment of recurrent pyoge nic cholangitis requires definition of the patients' intrahepatic dist ribution of disease, prior to surgical intervention, and the coordinat ed efforts of gastroenterologists, radiologists, and surgeons. (C) 199 8 by Excerpta Medica, Inc.