Reappraisal of the role of the bilioenteric conduit in the pathogenesis of postoperative cholangitis

Jiin Haur Chuang*, Shin Ye Lee, Chie Song Shieh, Wei Jen Chen, Nyuk Kong Chang

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

17 Scopus citations


The incidence of postoperative cholangitis has changed very little despite progressive improvement in the treatment of biliary atresia. The role of the bilioenteric conduit in its pathogenesis is still uncertain. A retrospective study of 39 patients undergoing either a conventional Kasai operation (group 1, n = 20) or with placement of an antireflux valve (group 2, n = 10) or lengthening (group 3, n = 9) of the jejunal conduit from 40 to 60 cm was performed to compare the incidence of cholangitis. Postoperative cholangitis developed in 18 of the 39 patients (46%). The incidence was 10/20 (50%) in group 1, 5/10 (50%) in group 2, and 3/9 (33%) in group 3 (P = 0.679). An animal experiment was conducted concomitantly to compare quantitative bacterial cultures of the bilioenteric anastomosis and the liver before and 1 week after Roux-en-Y hepaticojejunostomy (HPJ) in piglets without (group A, 25 cm) and with (group B, 50 cm) lengthening of the jejunal conduit in a porcine model of extrahepatic biliary obstruction. The growth of bacteria in both the bilioenteric anastomosis and the liver was not affected by lengthening the jejunal conduit from 25 to 50 cm (P = 0.612 and 0.057, respectively), despite a geometric increase in bacterial concentrations in both groups after HPJ. It is concluded that neither bacterial growth in the liver nor cholangitis following bile-duct reconstruction was affected by valving or lengthening the bilioenteric conduit.

Original languageEnglish
Pages (from-to)29-34
Number of pages6
JournalPediatric Surgery International
Issue number1-2
StatePublished - 01 2000
Externally publishedYes


  • Biliary atresia
  • Cholangitis
  • Hepaticojejunostomy


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