All of following are true regarding recurrent pyogenic cholangitis except

Recurrent pyogenic cholangitis Infection is caused by bacterial contamination usually biliary pathogens, and biliary parasites, such as clonorchis sinensis, opisthorchis viverrini and Ascaris lumbricoides Paial obstruction of biliary tree caused by biliary sludge and dead bacterial cell bodies, which form brown pigment stones. Clinical features Patients present with frequent episodes of pain, fever and jaundice Biliary strictures and repeated episodes of cholangitis are the common, may lead to liver abscess and cirrhosis GB stones are present in <50% cases Ref: Sabiston 20th edition. Pgno :1507-1508