A Taiwanese Woman with Acute Cholangitis

Moderator's Introduction

I am very pleased to introduce not one but two Guest Discussants, the Canadian dynamic duo of gastrointestinal endoscopy and surgery, Drs Alan and Jeff Barkun. After years of study, I am now able to tell these twins apart: Jeff is the one who looks confused when you call him “Alan,” and vice versa. Dr Alan Barkun spent some time at Duke University during his training. I have been pleased to watch his emergence as an expert in endoscopic outcomes research. Dr Jeff Barkun provides the important surgical balance in the Barkun Brothers team. We appreciate your willingness to review a case for us, gentlemen!

References

• 1 Leung J W, Ling T K, Chan R C, et al. Antibiotics, biliary sepsis and bile duct stones.  Gastrointest Endosc. 1994;  4 716-721
• 2 Csendes A, Diaz J C, Burdiles P, et al. Risk factor and classification of acute suppurative cholangitis.  Br J Surg. 1992;  79 655-658
• 3 Lai E C, Mok F P, Tan E S, et al. Endoscopic biliary drainage for severe acute cholangitis.  N Engl J Med. 1992;  326 1582-1586
• 4 Canadian Task Force on the Periodic E xamination. The periodic health examination: 1. Introduction.  Can Med Assoc J. 1986;  134 721-723
• 5 Faylona J M, Qadir A, Chan A C, et al. Small-bowel perforations related to endoscopic retrograde cholangiopancreatography (ERCP) in patients with Billroth II gastrectomy.  Endoscopy. 1999;  31 546-549
• 6 Freeman M L, Nelson D B, Sherman S, et al. Complications of endoscopic biliary sphincterotomy.  N Engl J Med. 1996;  335 909-18
• 7 Lai E C, Peterson I A, Tam P C, et al. Severe acute cholangitis: the role of emergency nasobiliary drainage.  Surgery. 1990;  107 268-272
• 8 Van Sonnenberg E, Casola G, Cubberley D A, et al. Oriental cholangiohepatitis: Diagnostic imaging and interventional management.  AJR Am J Roentgenol. 1986;  146 327-331
• 9 Mehta S N, Barkun A N, Reinhold C. Magnetic resonance cholangio-pancreatography.  Gastrointest Endosc Clin N Am. 1997;  7 247-270
• 10 Mehta S, Pavone E, Barkun J S, et al. A review of the management of post-cholecystectomy biliary leaks during the laparoscopic era.  Am J Gastroenterol. 1997;  92 1262-1267
• 11 Davids P HP, Tanka A KF, Rauws E AJ, et al. Benign biliary strictures: surgery or endoscopy?.  Ann Surg. 1993;  217 237-243
• 12 Pitt H A, Miyamoto T, Parapatis S K, et al. Factors influencing outcome in patients with postoperative biliary strictures.  Am J Surg. 1982;  144 14-21
• 13 Kim M H, Sekijima J, Lee S P. Primary intrahepatic stones.  Am J Gastroenterol. 1995;  9 540-548
• 14 Chen M F, Jan Y Y, Wang C S, et al. A reappraisal of cholangiocarcinoma in patients with hepatolithiasis.  Cancer. 1993;  71 2461-2465
• 15 Lim J H, Ko Y T, Lee D H, et al. Oriental cholangiophepatitis: sonographic findings in 48 cases.  AJR Am J Roentgenol. 1990;  155 511-514
• 16 Fan S T, Choi T K, Wong J. Recurrent pyogenic cholangitis: current management.  World J Surg. 1991;  15 248-253
• 17 Todani T, Watanabe Y, Narusue M, et al. Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst.  Am J Surg. 1977;  134 (2) 263-269
• 18 Kaneko K, Ando H, Watanabe Y, et al. Secondary excision of choledochal cysts after previous cyst-enterostomies.  Hepatogastroenterology. 1999;  46 (29) 2772-2775
• 19 Chapman R W. Risk factors for biliary tract carcinogenesis.  Ann Oncol. 1999;  10 Suppl 4 308-311
• 20 Kim S H, Lim J H, Yoon H K, et al. Choledochal cyst: comparison of MR and conventional cholangiography.  Clin Radiol. 2000;  55 (5) 378-383