Oriental cholangiohepatitis – Is our surgery appropriate?

•How to grade the disease before surgery.•Use of access loops internal and external.•Proper referral to high volume centers.•Avoiding unwanted surgeries.

Oriental cholangiohepatitis, or recurrent pyogenic cholangitis is only noted in certain parts of the world, especially South East Asia. Due to increasing immigration the disease is now being seen in western countries also. Treating physicians may face difficulty in managing such cases due to lack of exposure. Furthermore management of such cases is not standardized because of lack of a universally accepted classification system. Here we review the disease and share our long experience with management of these patients.