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| Recurrent pyogenic cholangitis: An indication for liver transplantation |
| Wong Hoi She, Wing Chiu Dai, James YY Fung, Tan To Cheung, Albert CY Chan ∗, Chung Mau Lo |
Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China
∗ Corresponding author.
E-mail address: acchan@hku.hk (A.C. Chan). |
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Abstract Recurrent pyogenic cholangitis (RPC), also known as Hong Kong disease [1] , is an unique disease entity with a decreasing incidence. It is characterized by the formation of intrahepatic biliary pigmented stones, which results in stricturing of the biliary tree followed by obstruction and repeated attacks of cholangitis. Inadequate treatment eventually leads to liver abscess, parenchymal atrophy, complications of cirrhosis including end-stage liver disease, and risk of cholangiocarcinoma. Treatment for RPC in the initial phase of presentation include sepsis control with antibiotics and drainage of the biliary system, either endoscopically or radiologically. Definitive management requires surgery such as partial hepatectomy and/or hepaticocutaneous jejunostomy. The formation of the cutaneous limb would allow subsequent clearance of intrahepatic ductal stones by endoscopic means. Whether to perform hepatectomy or not would depend on the severity of cirrhosis and the presence of stones, liver abscess, and liver atrophy. Liver transplantation (LT) has been reported as a potential treatment option for patients with diffuse bilateral RPC [2] or secondary biliary cirrhosis. However, the evidence is scarce. We shall report a series of our patients who received LT as the definitive treatment for RPC.
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2022, Vol. 21 
