Search Our Scientific Publications & Authors

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 May 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 Feb 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

Z Gastroenterol 2015 Sep 14;53(9):1087-90. Epub 2015 Sep 14.

Innere Medizin I, Universitätsklinikum Tübingen, Germany.

Recurrent Pyogenic Cholangitis (RPC) or Primary Hepatolithiasis is a common disease of the biliary tract in Asia, whereas it is usually not seen in Europeans. With increasing global mobility, the disease will be encountered in Europe more frequently, too. It should therefore be considered as a differential diagnosis in patients from endemic countries with recurrent symptoms of cholestasis/cholangitis and bile duct dilations, strictures and hepatolithiasis. Read More

J Community Hosp Intern Med Perspect 2015 1;5(4):27858. Epub 2015 Sep 1.

Division of Gastroenterology, St. Mary's Medical Center, San Francisco, CA, USA.

Recurrent pyogenic cholangitis (RPC) is a clinical syndrome characterized by repeated episodes of suppurative cholangitis due to hepatolithiasis and extrahepatic stones in the biliary ducts. It is now recognized as a distinct syndrome with a different natural history and pathoetiology than spontaneously occurring liver abscesses. Most commonly seen in East Asian populations, this syndrome is growing increasingly common in Western Nations due to migration patterns. Read More

ANZ J Surg 2015 Jun;85(6):491-2

Dig Dis Sci 2015 Jun 29;60(6):1801-4. Epub 2015 Jan 29.

Department of Medicine, Los Angeles County Hospital, Keck School of Medicine, University of Southern California, D & T Building Room B4H100, 1983 Marengo St., Los Angeles, CA, 90033-1370, USA,

Background: As the survival of cystic fibrosis patients improves due to better treatment of its pulmonary manifestations, the management of hepatobiliary complications becomes increasingly vital. While focal biliary cirrhosis is common, large duct manifestations are less frequently encountered.

Methods: We prospectively evaluated cases of large bile duct disease in a large adult cystic fibrosis practice at the Keck Hospital of the University of Southern California. Read More

Hum Pathol 2015 Mar 9;46(3):426-33. Epub 2014 Dec 9.

Department of Pathology, University of Chicago, Chicago, IL 60637. Electronic address:

The aim of this study was to review the clinical, radiographic, and pathologic features of cases of benign segmental cholangiectasia in non-Asian US patients with clinical concern for cholangiocarcinoma and compare these features with cases of recurrent pyogenic cholangitis (RPC) in Asian patients. A total of 10 non-Asian US patients with benign segmental cholangiectasia were included in this study. Nine of them underwent partial hepatic resection due to cholangiographic findings of segmental cholangiectasia with mural thickening and/or proximal biliary stricture. Read More

J Glob Infect Dis 2014 Apr;6(2):65-72

Department of Medicine and I/C Hepatology Clinic, Assam Medical College, Dibrugarh, Assam, India.

Ascariasis mainly contributes to the global helminthic burden by infesting a large number of children in the tropical countries. Hepato-biliary ascariasis (HBA) is becoming a common entity now than in the past owing to the frequent usage of ultrasonograms and endoscopic diagnostic procedures in the clinical practice. There are a variety of manifestations in HBA and diagnosis depends on a high index of suspicion in endemic areas coupled with subsequent confirmation by sonographic or endoscopic demonstration of the worm. Read More

Int J Surg 2014 8;12(8):789-93. Epub 2014 Jun 8.

Department of General Surgery, Sher I Kashmir Institute of Medical Sciences, Srinagar, Kashmir, 190011, India.

Oriental cholangiohepatitis, or recurrent pyogenic cholangitis is only noted in certain parts of the world, especially South East Asia. Due to increasing immigration the disease is now being seen in western countries also. Treating physicians may face difficulty in managing such cases due to lack of exposure. Read More

Radiographics 2014 May-Jun;34(3):565-86

From the Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, Tex (V.S.K.); and Department of Radiology, University of Pittsburgh Medical Center, Presby South Tower, Suite 4895, 200 Lothrop St, Pittsburgh, PA 15213 (A.K.D., N.D., K.H.).

Bile duct strictures in adults are secondary to a wide spectrum of benign and malignant pathologic conditions. Benign causes of bile duct strictures include iatrogenic causes, acute or chronic pancreatitis, choledocholithiasis, primary sclerosing cholangitis, IgG4-related sclerosing cholangitis, liver transplantation, recurrent pyogenic cholangitis, Mirizzi syndrome, acquired immunodeficiency syndrome cholangiopathy, and sphincter of Oddi dysfunction. Malignant causes include cholangiocarcinoma, pancreatic adenocarcinoma, and periampullary carcinomas. Read More

HPB (Oxford) 2014 Aug 7;16(8):776-80. Epub 2013 Nov 7.

Department of Surgery, Tung Wah Hospital, University of Hong Kong, Hong Kong, China.

Background: Recurrent pyogenic cholangitis (RPC) is common in Asia. Its management differs from centre to centre.

Methods: A retrospective review of 80 patients undergoing surgery for RPC was performed. Read More

ISRN Surg 2013 25;2013:536081. Epub 2013 May 25.

Hepatopancreaticobiliary Service, Department of General Surgery, Changi General Hospital, Singapore 529889.

Recurrent pyogenic cholangitis (RPC) is characterized by repeated infections of the biliary system with the formation of stones and strictures. The management aims are to treat acute cholangitis, clear the biliary ductal debris and calculi, and eliminate predisposing factors of bile stasis. Operative options include hepatectomy and biliary drainage procedures or a combination of both; nonoperative options include endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) guided procedures. Read More

World J Gastroenterol 2013 Jan;19(3):375-80

Department of Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan.

Aim: To compare the outcomes of concomitant cholangiocarcinoma (C-CCA) and subsequent cholangiocarcinoma (S-CCA) associated with hepatolithiasis.

Methods: From December 1987 to December 2007, 276 patients underwent hepatic resection for hepatolithiasis in Changhua Christian Hospital. Sixty-five patients were excluded due to incomplete medical records and the remaining 211 patients constituted our study population base. Read More

Srp Arh Celok Lek 2012 Nov-Dec;140(11-12):772-6

School of Medicine, University of Belgrade, Belgrade, Serbia

Introduction: Biliobronchial fistula is rare. Very rarely it may be congenital, more frequently it is acquired as a complication of the hydatide cyst of the liver, pyogenic abscess, serious trauma and resection of the liver as well as recurrent cholangitis due to benign bile duct stricture or cholangiolithiasis. The main causes of the biliobronchial fistula are billiary obstruction and infectious lesion (abscess) in the liver. Read More

Indian J Surg 2011 Aug 15;73(4):309-11. Epub 2011 Apr 15.

Department of Surgical Gastroenterology, School of Digestive and Liver Diseases, I.P.G.M.E.R., Kolkata, 20 India.

Recurrent pyogenic cholangitis is managed mostly by conservative treatment or by clearance of stones and biliary enteric by-pass procedure. Hepatectomy is rarely needed. We report a case of recurrent pyogenic cholangitis in a 34-year old man, who presented with recurrent upper abdominal pain, mild jaundice, and fever since childhood. Read More

Korean J Hepatobiliary Pancreat Surg 2012 Aug 31;16(3):105-9. Epub 2012 Aug 31.

Department of Surgery, Chungnam National University Hospital, Daejeon, Korea.

Backgrounds/aims: Recently many studies have been reported the early results of a hepatectomy for various intrahepatic lesions. Also various types of laparoscopic hepatectomies are being performed in many centers. Some reports about the safety of laparoscopic parenchymal dissection of the liver have been published. Read More

Gastroenterol Hepatol 2012 Oct 30;35(8):572-6. Epub 2012 May 30.

Unidad Clínica de Aparato Digestivo, Hospital Universitario San Cecilio, Granada, España.

Recurrent pyogenic cholangitis (RPC), or oriental cholangiohepatitis, is characterized by intrabiliary pigment stone formation, whose main manifestation consists of recurrent episodes of cholangitis, although other biliopancreatic complications can also occur. RPC develops mainly in Asian patients, in whom this entity is one of the main causes of acute abdominal pain. The differential diagnosis should be established with all other entities associated with intrahepatic stone formation, which is more common in Asian countries compared with the predominance of gallstone formation in the West. Read More

Ann Hepatol 2012 Mar-Apr;11(2):268-71

Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey.

Recurrent pyogenic cholangitis is endemic to South-east Asia but has been very rarely reported from natives of other parts of the world. A 43-years-old woman was presented with sepsis that had a history of recurrent epigastric pain and fever attacks. Her liver tests were unremarkable suggesting any hepatobiliary diseases. Read More

Abdom Imaging 2012 Oct;37(5):767-74

Health Promotion Center, Asan Medical Center, University of Ulsan, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea.

Purpose: To assess MR findings and diagnostic performance for differentiating malignant from benign hepatic masses in recurrent pyogenic cholangitis (RPC).

Materials And Methods: During a recent 6-year period, we performed MRI in 352 patients with RPC. Among them, 58 had confirmed hepatic masses; cholangiocarcinoma (n = 15), abscess (n = 37), inflammatory pseudotumor (n = 3), biloma (n = 3). Read More

Surg Laparosc Endosc Percutan Tech 2011 Dec;21(6):e319-21

Department of Urology, Amrita Institute of Medical Sciences and Research Centre, Kochi, India.

Several minimally invasive procedures have been successfully used for removal of stones from the hepatobiliary system. We describe an innovative interventional radiologic procedure using rigid urologic instruments within the hepatobiliary system. Stones within the hepatic and bile ducts in a patient with recurrent pyogenic cholangitis were removed by a technique resembling percutaneous nephrolithotomy for renal stones. Read More

Surg Laparosc Endosc Percutan Tech 2011 Oct;21(5):e228-31

Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, China.

Purpose: To evaluate the technical feasibility and safety of robot-assisted laparoscopic Roux-en-Y hepaticojejunostomy, using the robotic surgical system.

Methods: This is a report of the use of robot-assisted laparoscopic Roux-en-Y hepaticojejunostomy on 2 patients with recurrent pyogenic cholangitis. Both had past history of side-to-side choledochoduodenostomy with complications of Sump syndrome and benign biliary stricture, respectively. Read More

Eur J Gastroenterol Hepatol 2011 Sep;23(9):770-7

Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong.

Background: Recurrent pyogenic cholangitis (RPC) is recognized as an important cause of pyogenic liver abscesses (PLA). Although it is endemic to Southeast Asia, it is seen increasing in the west mainly owing to immigration. The aim of this study is to compare the clinical characteristics of PLA in patients with RPC and without RPC. Read More

Adv Anat Pathol 2011 Jul;18(4):318-28

Department of Pathology, Caritas Medical Centre, Hong Kong, China.

Primary hepatolithiasis (HL), recurrent pyogenic cholangitis, and oriental cholangiohepatitis are terms commonly used in Japan, Hong Kong, and Korea respectively, and describing the different aspects of the same disease, with "HL" indicating the pathologic changes, "recurrent pyogenic cholangitis" emphasizing the clinical presentation and suppurative inflammation, and "oriental cholangiohepatitis" highlighting its ethnic preference and mysterious nature. HL is predominantly a disease of the far east and shows great regional differences in the incidence and the type of intrahepatic stones. Pathologically, it is characterized by pigmented calcium bilirubinate stones within dilated intrahepatic bile ducts featuring chronic inflammation, mural fibrosis, and proliferation of peribiliary glands, without extrahepatic biliary obstruction. Read More

Korean J Radiol 2011 May-Jun;12(3):269-79. Epub 2011 Apr 25.

Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.

Liver fluke disease is a chronic parasitic inflammatory disease of the bile ducts. Infection occurs through ingestion of fluke-infested, fresh-water raw fish. The most well-known species that cause human infection are Clonorchis sinensis, Opisthorchis viverrini and Opisthorchis felineus. Read More

Semin Liver Dis 2011 Feb 22;31(1):33-48. Epub 2011 Feb 22.

Department of Pathology, Caritas Medical Centre, Hong Kong, China.

Primary hepatothiasis (HL) and recurrent pyogenic cholangitis (RPC) are two terms describing the different aspects of the same disease, with HL emphasizing the pathologic changes and RPC emphasizing the clinical presentation and suppurative inflammation. It is predominantly a disease of the Far East. In the 1960s, it was the third most common cause of emergency abdominal surgery at a university hospital in Hong Kong. Read More

Surgeon 2011 Apr;9(2):88-94

Division of Hepatopancreatobiliary Surgery, Digestive Disease Center, Department of Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 304833, Singapore.

Background: Hepatolithiasis is a challenging condition to treat especially in patients with previous hepatobiliary surgery. Percutaneous Transhepatic Cholangioscopic Lithotripsy (PTCSL) is an attractive salvage option for the treatment of recurrent hepatolithiasis. We reviewed our experience using PTCSL in treating 4 patients with previous complex abdominal surgery. Read More