Introduction Recurrent pyogenic cholangitis is a common condition in Hong Kong. Digby1 drew attention to its occurrence in Hong Kong in a paper in which he described 8 cases. Cook2 et al. described the clinical aspects in 1954, while Stock and Tinckler3 reported the result of their treatment in cases of cholangiohepatitis, a name suggested by Himsworth4 in 1947 for a similar condition associated with obstruction of the large bile ducts outside the liver resulting from either an impacted stone or carcinoma of the large bile ducts. Although the pathological picture is that of inflammation of the liver parenchyma as well as the bile ducts, the term recurrent pyogenic cholangitis as used by Cook et al. is probably more appropriate for the pathological change most evident in the bile ducts, with the liver parenchyma being secondarily involved. This condition is characterized by Charcot's intermittent biliary fever