[Opisthorchiasis-induced suppurative cholangitis (clinical course and diagnosis)].

Purulent cholangitis was found in 128 (44.6 per cent) of the 288 patients operated on for complicated forms of opisthorchiasis. Mechanical cholestasis due to sclerotic changes in the bile ducts, major duodenal papilla and pancreas is the most responsible factor in disease prognosis. Esophagogastroduodenoscopy, ultrasound examination, intra-operative cholangiography and fibrocholedochoscopy are used for diagnosis as well as study of bile microflora in the common bile duct. The acute form of purulent cholangitis was attended by acute liver insufficiency in 42.4 per cent of the cases; fatal outcomes took place in 8.2 per cent. Cholecystectomy must be supplemented by the restoration of passage of bile in the duodenum with external drainage of the bile ducts to eliminate bacterial flora and helminths.