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

Eur J Clin Microbiol Infect Dis. 2022 Aug;41(8):1139-1143. doi: 10.1007/s10096-022-04468-7. Epub 2022 Jul 18.

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.

Keywords: Acute cholangitis; Biliary reflux; Bilioenteric anastomosis.

MeSH terms

  • Anastomosis, Surgical / adverse effects
  • Anti-Bacterial Agents / therapeutic use
  • Cholangitis* / surgery
  • Humans
  • Reoperation

Substances

  • Anti-Bacterial Agents