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Arab J Gastroenterol 2021 Mar 19. Epub 2021 Mar 19.

Department of Gastroenterology, School of Digestive and Liver Diseases (SDLD), IPGMER & SSKM Hospital, Kolkata, India.

Background And Study Aims: Anti-helminthic therapy and endoscopic worm extraction had variable success rates in biliary ascariasis. Recurrent biliary events after worm clearance are common. We aimed to evaluate the outcomes of management in biliary ascariasis and find out the incidence and risk factors for the development of recurrent biliary events. Read More

World J Gastroenterol 2021 Jan;27(4):371-376

Internal Medicine, Eunpyeong St. Mary's Hospital, Catholic University of Korea, Seoul 03312, South Korea.

Background: Duplication of the extrahepatic bile duct (DCBD) is an extremely rare congenital anomaly of the biliary system. There are five types of DCBD according to the latest classification. Among them, Type V is characterized by single drainage of the extrahepatic bile ducts. Read More

Recent Pat Inflamm Allergy Drug Discov 2020 ;14(2):133-145

Department of Paediatrics, The Chinese University of Hong Kong, and Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Shatin, Hong Kong.

Background: Ascaris lumbricoides is the most common helminthic infection. More than 1.2 billion people have ascariasis worldwide. Read More

J Clin Exp Hepatol 2019 Nov-Dec;9(6):749-752. Epub 2019 Mar 27.

Department of Hepatology, Institute of Liver and Biliary Sciences, D1 Vasant Kunj, New Delhi, India.

Recurrent pyogenic cholangitis (RPC) is a disease characterized by multiple strictures of the biliary tree, impaired biliary drainage, formation of intrahepatic biliary pigment stones and recurrent bouts of cholangitis. We report the case of a 39-year-old businessman with diagnosed chronic calcific pancreatitis, who presented to us with recurrent episodes of cholangitis, leading to portal pyaemia, and progressive liver failure, which could not be controlled despite adequate biliary drainage. The patient rapidly developed progressive liver failure and sepsis-related coagulation failure. Read More

Surg Endosc 2020 05 16;34(5):2000-2006. Epub 2019 Jul 16.

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.

Background: The development of robotic system may help to relieve the difficulties encountered during laparoscopic hepatectomy. A difficulty scoring system (DSS) was developed to assess the difficulty of various laparoscopic liver resection procedures. The aim of this study is to explore if the DSS is applicable in robotic hepatectomy and to compare the outcomes of robotic hepatectomy and laparoscopic hepatectomy among different difficulty levels. Read More

Frontline Gastroenterol 2019 Jul 4;10(3):284-291. Epub 2019 Jan 4.

Department of Hepatology and Liver Transplantation, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Cholangiopathies describe a group of conditions affecting the intrahepatic and extrahepatic biliary tree. Impairment to bile flow and chronic cholestasis cause biliary inflammation, which leads to more permanent damage such as destruction of the small bile ducts (ductopaenia) and biliary cirrhosis. Most cholangiopathies are progressive and cause end-stage liver disease unless the physical obstruction to biliary flow can be reversed. Read More

Clin Gastroenterol Hepatol 2020 02 25;18(2):449-456. Epub 2019 Jun 25.

Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China; State Key Laboratory of Liver Research, University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China. Electronic address:

Background & Aims: In some individuals with undetectable serum levels of hepatitis B surface antigen (HBsAg), hepatitis B virus (HBV) DNA can still be detected in serum or hepatocytes and HBV replicates at low levels-this is called occult HBV infection (OBI). OBI has been associated with increased risk of hepatocellular carcinoma (HCC). We investigated the incidence of OBI in patients with HCC and other liver diseases. Read More

Gut Liver 2019 05;13(3):373-379

Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.

Background/aims: Recurrent pyogenic cholangitis (RPC) is a chronic progressive disease frequently accompanied by cholangiocarcinoma (CCA). This study aimed to investigate the natural course of RPC and identify factors associated with CCA.

Methods: From January 2005 to December 2016, 310 patients diagnosed with RPC at Seoul National University Hospital were included. Read More

HPB (Oxford) 2019 01 28;21(1):132. Epub 2018 Sep 28.

The 2nd Department of Hepatobiliary Surgery, Meizhou People's Hospital, Guangdong 514021, China. Electronic address:

Ann Hepatobiliary Pancreat Surg 2018 Aug 31;22(3):282-286. Epub 2018 Aug 31.

Department of General Surgery, Khoo Teck Puat Hospital, Singapore.

Percutaneous transhepatic biliary drainage (PTBD) is safe treatment for biliary decompression given certain indications. However, this is temporary until definitive drainage is established. We report on a 76-year-old lady with recurrent pyogenic cholangitis and PTBD catheter fracture. Read More

HPB (Oxford) 2018 11 14;20(11):1067-1072. Epub 2018 Jul 14.

Department of Surgery, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China.

Background: Recurrent pyogenic cholangitis (RPC) is a known risk factor for intrahepatic cholangiocarcinoma (ICC), whether it represents a poor prognostic factor remains controversial. The aim of this study was to investigate the post-hepatectomy oncological outcomes of patients with ICC and coexisting RPC.

Method: A retrospective analysis with propensity score matching (PSM) was performed for comparison between ICC patient with and without RPC. Read More

Indian J Surg 2018 Feb 19;80(1):98-99. Epub 2017 Dec 19.

Department of Surgical Gastroenterology, Apollo Hospitals, Bhubaneswar, 751012 India.

We report the "Christmas tree" sign on the magnetic resonance cholangiogram in two patients with left-sided cholangiohepatitis. Read More

ANZ J Surg 2018 09 11;88(9):E659-E663. Epub 2017 Dec 11.

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.

Background: Recurrent pyogenic cholangitis (RPC) has a high risk of disease recurrence. We present our experience with RPC and examine the factors associated with disease recurrence.

Methods: We performed a retrospective review of all patients with RPC treated at two tertiary institutions between January 1990 and December 2013. Read More

Abdom Radiol (NY) 2017 Dec;42(12):2964-2965

Department of Radiology, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, Hong Kong SAR.

Int J Surg Case Rep 2017 20;33:16-20. Epub 2017 Feb 20.

Medanta Institute of Liver Diseases and Transplantation, Medanta-The Medicity, Delhi, NCR, India.

Introduction: Robotic surgical system's ability to perform complex hepatobiliary surgeries is gaining momentum with outcomes similar to open surgery and advantages of minimal access surgery. The authors present their initial experience of a heterogenous spectrum of robotic hepatobiliary cases and the first reported case series from India.

Methods: Retrospective review of hepatobiliary cases done robotically from February 2015 to January 2016 was done. Read More

Endoscopy 2017 Feb 9;49(S 01):E5-E6. Epub 2017 Jan 9.

Division of Gastroenterology and Hepatology, Weil Cornell Medical College, Cornell University New York, New York, USA.

Neth J Med 2016 Nov;74(9):401-405

Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, the Netherlands.

Oriental cholangiohepatitis is a condition occurring in the Asian population, characterised by recurrent bacterial cholangitis and presence of calculi within the intrahepatic bile ducts, biliary strictures and an increased risk for cholangiocarcinoma. It is an uncommon disease in the West that may not always be considered. The therapeutic approach is multidisciplinary and highly individual, and includes antibiotic therapy, endoscopic and percutaneous biliary drainage with stone removal and dilation of strictures, and in selected cases surgical resection of affected liver segments. Read More

Abdom Radiol (NY) 2017 01;42(1):46-56

Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore.

Recurrent pyogenic cholangitis (RPC) is an infective process involving the biliary tree typified by pigmented intraductal calculi with dilatation of the intra- and extrahepatic biliary tree. Previously endemic to South-east Asia, RPC can now be seen in Western countries with the increasing access to international travel and immigration. Affected patients are often plagued by recurrent bouts of cholangitis, and commonly suffer from complications such as abscess formation and biliary strictures. Read More

Dig Dis Sci 2016 Nov 24;61(11):3147-3150. Epub 2015 Nov 24.

Division of Surgical Oncology, Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Suite H3680A, Stanford, CA, 94305, USA.

World J Gastroenterol 2016 Sep;22(33):7507-17

Mohammad S Khuroo, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir 190010, India.

Hepatobiliary and pancreatic ascariasis (HPA) was described as a clinical entity from Kashmir, India in 1985. HPA is caused by invasion and migration of nematode, Ascaris lumbricoides, in to the biliary tract and pancreatic duct. Patients present with biliary colic, cholangitis, cholecystitis, hepatic abscesses and acute pancreatitis. Read More

HPB (Oxford) 2016 10 28;18(10):821-826. Epub 2016 Jun 28.

Division of Surgical Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020, West Bengal, India.

Background: Although, recurrent pyogenic cholangitis (RPC) is prevalent in several parts of India, there is paucity of published literature from India. The aim of this study was to report on the short and long-term outcomes of surgery for RPC.

Methods: All the patients, who underwent surgery for RPC between August 2007 and February 2016 in the Department of Surgical gastroenterology, Institute of Postgraduate Medical Education and Research, Kolkata, India were retrospectively reviewed. Read More

J Emerg Med 2016 Oct 25;51(4):e79-e83. Epub 2016 Jul 25.

Department of Gastroenterology, Topiwala National Medical College and BYL Ch Hospital, Mumbai, Maharashtra, India.

Background: Acute encephalopathy in a patient with alcoholic liver disease (ALD) is a commonly encountered emergency situation occurring most frequently due to liver failure precipitated by varying etiologies. Acute reversible cerebellar ataxia with confusion secondary to prolonged metronidazole use has been reported rarely as a cause of encephalopathy in patients with ALD.

Case Report: We describe a decompensated ALD patient with recurrent pyogenic cholangitis associated with hepatolithiasis who presented to the emergency department with sudden-onset cerebellar ataxia with dysarthria and mental confusion after prolonged use of metronidazole. Read More

F1000Res 2016 17;5. Epub 2016 Jun 17.

Department of Medicine, Division of Gastroenterology , University of Washington School of Medicine, Seattle, WA, USA.

A variety of diseases are included under the umbrella term 'cholangitis', including hepatobiliary diseases with an autoimmune pathogenesis (such as primary sclerosing cholangitis, primary biliary cholangitis, and IgG4-associated sclerosing cholangitis) and disease processes associated with intraductal stones and infectious etiologies (such as ascending bacterial cholangitis, recurrent pyogenic cholangitis, and liver fluke-associated cholangitis). Recent advances in the pathophysiologic bases of these disorders, particularly with respect to the autoimmune variety, are allowing improved diagnosis and prognostication as well as providing the opportunity to refine and re-imagine treatment modalities. The aim of this review is to highlight selected advances in cholangitis research that point to novel insights into the pathophysiology, diagnosis, and treatment of this diverse array of disorders. Read More

Abdom Radiol (NY) 2016 Mar;41(3):553-67

Department of Radiology, Northwestern University, NMH/Arkes Family Pavilion Suite 800, 676 N Saint Clair, Chicago, IL, 60611, USA.

Cholangiocarcinoma, a tumor of biliary epithelium, is increasing in incidence. The imaging appearance, behavior, and treatment of cholangiocarcinoma differ according to its location and morphology. Cholangiocarcinoma is usually classified as intrahepatic, perihilar, or distal. Read More

Korean J Radiol 2016 Jan-Feb;17(1):25-38. Epub 2016 Jan 6.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.

Sclerosing cholangitis is a spectrum of chronic progressive cholestatic liver disease characterized by inflammation, fibrosis, and stricture of the bile ducts, which can be classified as primary and secondary sclerosing cholangitis. Primary sclerosing cholangitis is a chronic progressive liver disease of unknown cause. On the other hand, secondary sclerosing cholangitis has identifiable causes that include immunoglobulin G4-related sclerosing disease, recurrent pyogenic cholangitis, ischemic cholangitis, acquired immunodeficiency syndrome-related cholangitis, and eosinophilic cholangitis. Read More

Indian J Surg 2015 Aug 21;77(4):338-40. Epub 2015 Jun 21.

Medanta Institute of Liver Diseases and Transplantation, Medanta-The Medicity, Gurgaon, Haryana India.

Robotic surgical platform is being increasingly used by liver surgeons for performing minimal invasive liver surgery, with results comparable to open surgery and added benefits of laparoscopic approach. The authors describe a case of robotic left hepatectomy done for recurrent pyogenic cholangitis. This is the first reported case of robotic hepatectomy done in India. Read More

Eur Radiol 2016 Sep 22;26(9):3112-20. Epub 2015 Dec 22.

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.

Objectives: To evaluate thread sign of biliary intraductal papillary mucinous neoplasm (B-IPMN) on magnetic resonance imaging (MRI).

Methods: Thread sign was defined as intraductal linear or curvilinear hypointense striations. Two radiologists independently evaluated the presence and location of thread sign on MR cholangiography (thin-slice, thick-slab and 3D MRC) and axial MR images (T2 TSE, T2 HASTE and DWI) in patients with B-IPMN (n = 38) and in matched control groups with benign (n = 36) or malignant (n = 35) biliary diseases. Read More

ANZ J Surg 2016 Mar 30;86(3):122-6. Epub 2015 Sep 30.

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.

Background: Both laparoscopic and robotic hepatectomy have been adopted in our centre for selected patients with benign or malignant liver diseases. This article reports the perioperative outcomes of these two approaches and tries to determine any difference between them.

Methods: A retrospective review of prospectively collected data was performed for all patients who underwent laparoscopic hepatectomy (LH) and robotic hepatectomy (RH) in our institute. Read More