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Clinical and microbiological characteristics of reflux cholangitis following bilio-enteric anastomosis

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Abstract

Twenty-five patients with reflux cholangitis (RC) defined as acute cholangitis (AC) with normal abdominal imaging occurring > 3 months after bilioenteric anastomosis were described and compared to 116 AC patients with biliary obstruction (tumoral, lithiasis). RC episodes occurred a median 4.5 months after surgery; 18 (72%) had recurrent RC (n ≥ 3). RC episodes were less severe than obstructive AC; the outcome was favorable with short antibiotic courses and no selection of antibiotic-resistance. However, multiple recurrent RC occurred in 20 patients (80%). Prophylactic or pre-emptive antibiotics were successful in 3 and 11 patients. Revision surgery for jejunal loop lengthening was successful in 2/4 patients.

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Authors and Affiliations

  1. Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Université Rennes 1, Rennes, France

    Audrey Le Bot

  2. Service de Médecine Interne, Hôpital Beaujon, Assistance-Publique des Hôpitaux de Paris, Université Paris Cité, 100 boulevard du Général Leclerc, 92110, Clichy, France

    Aurélien Sokal, Bruno Fantin & Victoire de Lastours

  3. Service de Chirurgie Hépatobiliaire, Hôpital Beaujon, Assistance-Publique des Hôpitaux de Paris, Université Paris Cité, Clichy, France

    Anaïs Choquet & Alain Sauvanet

  4. Service de Gastro-Entérologie Et Pancréatologie, Hôpital Beaujon, Assistance-Publique des Hôpitaux de Paris, Université Paris Cité, Clichy, France

    Frédérique Maire

  5. IAME Research Group, UMR 1137, Université Paris Cité and INSERM, Paris, France

    Bruno Fantin & Victoire de Lastours

Authors
  1. Audrey Le Bot
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  2. Aurélien Sokal
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  3. Anaïs Choquet
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  4. Frédérique Maire
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  5. Bruno Fantin
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  6. Alain Sauvanet
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  7. Victoire de Lastours
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Contributions

ALB and VDL designed the study and wrote the paper. ALB, AC, and ASo collected clinical data. ASa and FM took care of patients and helped with their expertise on the subject. BF supervised and helped with the writing of the paper. All authors have read and commented the paper and have approved the manuscript.

Corresponding author

Correspondence to Victoire de Lastours.

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Ethics approval

Data collection for this work was declared to the French National Commission of Computing and Liberties (Commission Nationale de l’Informatique et des Libertés, CNIL, registration No: 2080377 on 4/4/2017) and was approved by the ethics committee of the French Infectious Diseases Society (CER-MIT, IRB no. 00011642).

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The authors declare no competing interests.

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Le Bot, A., Sokal, A., Choquet, A. et al. Clinical and microbiological characteristics of reflux cholangitis following bilio-enteric anastomosis. Eur J Clin Microbiol Infect Dis 41, 1139–1143 (2022). https://doi.org/10.1007/s10096-022-04468-7

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  • DOI: https://doi.org/10.1007/s10096-022-04468-7

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