The impact of antibiotic maintenance therapy on the incidence of biliary tract infection was evaluated in patients with recurrent cholangitis after resection of a malignancy at the hepatic confluence. Thirty-eight of 54 patients (70%) experienced episodes of cholangitis. In 14 of the 38 patients recurrent episodes of cholangitis caused a severe interruption of their daily life. These 14 were selected for antibiotic maintenance therapy. During maintenance therapy six patients experienced no further episodes of cholangitis and five patients a marked decrease in the frequency of episodes, while in three patients no improvement was seen. Antibiotic maintenance therapy can be highly successful in the treatment of recurrent cholangitis after resection of a malignancy at the hepatic hilum.