Management of biliary Ascaris lumbricoides in Kabul, Afghanistan: crossroads of advancing technology.

The case is presented of the successful removal of a dead Ascaris lumbricoides from the right hepatic duct of a middle aged woman from a rural province in Afghanistan. The case was started laparoscopically, but converted to an open procedure because of difficulty identifying the anatomic landmarks required to safely perform laparoscopic cholecystectomy. After worm removal, the common bile duct (CBD) was reconstructed with a Roux-en-Y hepaticojejunostomy. The patient was discharged on postoperative day 7 and was doing well when seen in the outpatient clinic 2 weeks later.