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Biliary ascariasis: spectrum of surgical problems and tactics

BACKGROUND: To discuss the clinical expression and technical variations involved in the surgical treatment of complicated biliary ascariasis. METHODS: Retrospective study of patients operated on to treat complicated biliopancreatic ascariasis in a five year period. RESULTS: We describe four cases of complicated biliary ascariasis affecting children (three pre-schoolers and one school-aged child), clinically expressed as pancreatic pseudocyst, obstructive icterus, cholangitis and multiple hepatic abscesses, all surgically treated. We discuss aspects of operative treatment for each one of these patients. CONCLUSION: There are many variations concerning clinical and surgical presentations of biliary ascariasis, and a number of surgical tactics are necessary to solve those cases. We are against the use of anti-helmintics before the clearance of biliary passages. Preferential compromise of young children makes it necessary to use adequate and miniaturized techniques and materials to operate on those small patients biliary passages.

Ascaris lumbricoides; Parasitic diseases; Biliary tract; Complications


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