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Bacteribilia and Cholangitis After Percutaneous Transhepatic Biliary Drainage for Malignant Biliary Obstruction

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Abstract

Cholangitis often develops after percutaneoustranshepatic biliary drainage (PTBD) for malignancy. Theaims of this retrospective study were to clarify wheThe ror not bacteribilia and cholangitis increase with time after PTBD and to define thepathogenesis of bacteribilia and cholangitis after PTBD.One hundred twenty-eight patients underwent PTBD formalignancy. Both the cumulative incidences ofbacteribilia (77%) and cholangitis (28%) showed an increasewith time after PTBD. In 78% of patients withbacteribilia, bacteria from intestinal flora weredetected in bile. Catheter malfunction (N = 17) or thepresence of undrained bile ducts (N = 7) inducedcholangitis. Proximal obstruction, because it oftenaccompanied undrained ducts, had higher incidences ofbacteribilia (P = 0.04) and cholangitis (P < 0.0001) than did distal obstruction. In conclusion,bacteribilia and cholangitis increase in incidence withtime after PTBD. The primary cause of bacteribilia isthe transpapillary reflux of intestinal flora. Catheter malfunction or undrained ducts causecholangitis, provided underlying bacteribilia ispresent.

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Authors
  1. Tatsuya Nomura
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  2. Yoshio Shirai
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  3. Katsuyoshi Hatakeyama
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Nomura, T., Shirai, Y. & Hatakeyama, K. Bacteribilia and Cholangitis After Percutaneous Transhepatic Biliary Drainage for Malignant Biliary Obstruction. Dig Dis Sci 44, 542–546 (1999). https://doi.org/10.1023/A:1026653306735

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