Cholangitis due to malignant obstruction of biliary outflow.

This study reports the clinical presentation and hospital course of 21 patients with cholangitis and malignant diseases, obstructing the biliary tree. Eleven of 21 patients had cholangitis as the initial presentation of biliary disease, and the diagnosis of carcinoma was made at operation or autopsy examination. A total of 14 patients with cholangitis had no prior biliary surgery. Patients who underwent operations to relieve biliary obstructions during episodes of cholangitis had greater incidences of resolution of cholangitis (eight of 14 patients) than those patients treated non-operatively (none of eight patients). Only five patients survived long enough to leave the hospital, but each of these patients were palliated by some sort of drainage procedure. These data suggest that a small portion of this high risk group of patients may benefit significantly from early operative therapy of their cholangitis.