Oriental cholangiohepatitis: Diagnostic imaging and interventional management

Diagnostic and therapeutic radiologic experience with six patients who had oriental cholangiohepatitis is described. These patients combined had 10 prior operations. Postoperatively each had recurrent cholangitis, numerous stones, concretions, and/or bile duct strictures. Diagnostically, sonography was valuable in the detection of intra- and extrahepatic stones and extrahepatic dilatation of ducts. An important pitfall in sonography was poor visualization of intrahepatic ductal dilatation (due to echogenic sludge filling the ducts) in most patients. CT was helpful diagnostically in all respects. Interventional procedures used postoperatively included percutaneous transhepatic cholangiography and biliary drainage, dilatation of strictures, Fogarty-type removal of intrahepatic stones, and flushing techniques. Most patients were treated during multiple sessions as outpatients. Cholangitis was the only complication from the procedures. Sectional imaging and interventional radiology perform valuable diagnostic and therapeutic roles in the pre- and postoperative management of patients with oriental cholangiohepatitis.