Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2023; 15(10): 2305-2319
Published online Oct 27, 2023. doi: 10.4240/wjgs.v15.i10.2305
Hepatobiliary tuberculosis in the developing world
Ma Jenina Angela Esguerra-Paculan, Jonathan Soldera
Ma Jenina Angela Esguerra-Paculan, Jonathan Soldera, Acute Medicine, University of South Wales, Cardiff CF37 1DL, United Kingdom
Author contributions: Esguerra-Paculan MJA and Soldera J participated in the concept and design research, drafted the manuscript and contributed to data acquisition, analysis and interpretation; Soldera J contributed to study supervision; all authors contributed to critical revision of the manuscript for important intellectual content.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jonathan Soldera, MD, MSc, Associate Professor, Staff Physician, Acute Medicine, University of South Wales, Llantwit Road, Pontypridd, Cardiff CF37 1DL, United Kingdom. jonathansoldera@gmail.com
Received: July 3, 2023
Peer-review started: July 3, 2023
First decision: July 18, 2023
Revised: July 31, 2023
Accepted: August 15, 2023
Article in press: August 15, 2023
Published online: October 27, 2023
Processing time: 116 Days and 9.1 Hours
Abstract
BACKGROUND

Hepatobiliary tuberculosis is a challenging disease that poses diagnostic difficulties due to its resemblance to other etiologies. Delayed diagnosis may lead to inadequate treatment, thus necessitating an urgent need for accurate diagnosis and appropriate management.

AIM

To systematically review case reports on hepatobiliary tuberculosis, focusing on symptomatology, diagnostic procedures, management, and outcomes to provide patient safety and ensure an uneventful recovery.

METHODS

A systematic search was conducted on PubMed from 1992 to 2022, using keywords such as hepatobiliary, liver, tuberculosis cholangitis, cholangiopathy, and mycobacterium. Only case reports or case series in English were included in the study, and research papers published as abstracts were excluded. The search yielded a total of 132 cases, which were further narrowed down to 17 case studies, consisting of 24 cases of hepatobiliary tuberculosis.

RESULTS

The 10 most common symptoms observed in these cases were fever, abdominal pain, weight loss, jaundice, anorexia, generalized weakness, pruritus, chills, fatigue, and chest pains. Objective findings in these cases included hepatomegaly, hepatic nodules, elevated liver enzymes, and elevated bilirubin. Computed tomography scan and ultrasound of the abdomen were the most useful diagnostic tools reported. Histologic demonstration of Mycobacterium tuberculosis confirmed the cases of hepatobiliary tuberculosis. Treatment regimens commonly used included Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol. Out of the 24 cases, 18 presented improvements while 4 had completely recovered.

CONCLUSION

Hepatobiliary tuberculosis is a disease that requires accurate diagnosis and appropriate management to avoid complications.

Keywords: Tuberculosis; Hepatic/diagnosis; Cholangitis; Sclerosing/complications; Ultrasonography; Interventional/methods; Biopsy; Needle/utilization; Treatment Outcome

Core Tip: Hepatobiliary tuberculosis presents diagnostic challenges due to its similarity to other conditions, emphasizing the need for timely and accurate diagnosis. This systematic review of 24 cases highlights the common symptoms, diagnostic procedures, and treatment outcomes. Fever, abdominal pain, weight loss, and jaundice were the most frequent symptoms observed. Computed tomography scan and ultrasound were effective diagnostic tools, while histologic confirmation confirmed the presence of Mycobacterium tuberculosis. Treatment with Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol showed positive outcomes in the majority of cases. This study underscores the importance of precise diagnosis and appropriate management to ensure successful recovery and patient safety.