Changes in bacterial concentration in the liver correlate with that in the hepaticojejunostomy after bile duct reconstruction: implication in the pathogenesis of postoperative cholangitis

Chuang, Jiin-Haur, Lee, Shin-Yi, Chen, Wei-Jen, Hsieh, Chie-Song, Chang, Nyuk-Kong and Lo, Sing Kai 2001, Changes in bacterial concentration in the liver correlate with that in the hepaticojejunostomy after bile duct reconstruction: implication in the pathogenesis of postoperative cholangitis, World journal of surgery, vol. 25, no. 12, pp. 1512-1518.

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Title Changes in bacterial concentration in the liver correlate with that in the hepaticojejunostomy after bile duct reconstruction: implication in the pathogenesis of postoperative cholangitis
Author(s) Chuang, Jiin-Haur
Lee, Shin-Yi
Chen, Wei-Jen
Hsieh, Chie-Song
Chang, Nyuk-Kong
Lo, Sing Kai
Journal name World journal of surgery
Volume number 25
Issue number 12
Start page 1512
End page 1518
Publisher Springer
Place of publication New York, N.Y.
Publication date 2001-12
ISSN 0364-2313
1432-2323
Summary Postoperative cholangitis is a frequent and unpredictable complication of unknown etiology following bile duct reconstruction (BDR), particularly for biliary atresia. This study was undertaken to correlate the growth of bacteria in the hepaticojejunostomy with that in the liver after BDR. Quantitative bacterial culture was done on the specimens taken from the liver and from the hepaticojejunostomy at 1 week (group 1, n = 7), 1 month (group 2, n = 7), and 2 months (group 3, n = 7) following BDR with Roux-en-Y hepaticojejunostomy in piglets after 2 weeks of common bile duct ligation. The histological examination of the liver and the hepaticojejunostomy, as well as serial monitoring of hemogram and liver function tests, were performed to correlate the findings with the bacterial concentration of the liver and the hepaticojejunostomy following BDR. The bacterial concentration of the hepaticojejunostomy, expressed as log10 colony-forming units per gram (log10 CFU/g) of the hepaticojejunostomy, showed a progressive decrease from 8.38 ± 1.36 in group 1, 7.07 ± 2.54 in group 2, to 3.56 ± 1.31 in group 3 (p = 0.001). The log10 CFU/g of the liver also showed a progressive decrease from 5.02 ± 1.59 in group 1, 3.16 ± 1.56 in group 2, to 2.19 ± 1.09 in group 3 (p = 0.006). There was a significant positive correlation of the log10 CFU/g of the liver (n = 21) with that of the hepaticojejunostomy (n = 21) following BDR (r = 0.600, p = 0.004). Most of the infectious pathogens isolated from the liver were also isolated from the hepaticojejunostomy. The changes in hemoglobin, bilirubin, albumin, and ammonia significantly correlated with the changes of the bacterial concentration of the liver. The results of the study suggests that hepatic bacterial proliferation after BDR is significantly affected by microbial overgrowth in the bilioenteric anastomosis and is associated with deteriorated liver function and hemogram.
Language eng
Field of Research 110306 Endocrinology
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2001, Société Internationale de Chirurgie
Persistent URL http://hdl.handle.net/10536/DRO/DU:30009350

Document type: Journal Article
Collection: School of Health and Social Development
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