Regular ArticleBacterial Translocation from the Biliary Tract to Blood and Lymph in Rats with Obstructive Jaundice
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Infectious complications of endoscopic retrograde cholangiopancreatography (ERCP)
2014, Techniques in Gastrointestinal EndoscopyCitation Excerpt :However, the procedure itself can lead to translocation of bacteria or secreted endotoxin from the infected bile ducts into the bloodstream with subsequent bacteremia and septic shock [2]. The mechanism is thought to involve increased biliary pressure causing cholangiovenous reflux [3-5]. To prevent this complication, when performing ERCP in patients with cholangitis, it is recommended to use the wire-guided technique for cannulation, to aspirate bile during the procedure so as to decrease biliary pressure, to minimize the injection of contrast, and especially to avoid occlusion cholangiography [6].
How to interpret the bile culture results of patients with biliary tract infections
2014, Clinics and Research in Hepatology and GastroenterologyCitation Excerpt :In short, the presence of bacteria in bile implies a carrier state, not an infection. Bacteremia in acute cholangitis is caused by a combination of colonized bile and increased bile duct pressure that favours the translocation of bacteria from the biliary tract to systemic circulation [18–20]. The dissemination of microbes and endotoxins via the blood stream activates a systemic inflammatory response and leads to septicemia and clinical features of cholangitis with chills and fever [21].
Restoration of hepatocytes function following decompression therapy in extrahepatic biliary obstructed patients: Metabolite profiling of bile by NMR
2011, Journal of Pharmaceutical and Biomedical AnalysisCitation Excerpt :Adequate palliation is desirable as prolonged obstruction causes jaundice, pruritis and progressive hepatocellular dysfunction with alteration in host defence system due to retention of bile [8,9]. This follows altered permeability of blood–bile barrier allowing regurgitation of biliary constituents into blood circulation and endotoxemia [10–15]. Biliary drainage via PTBD alleviates icterus, resolves infection, restores most of the changes of the liver parenchyma and recovery of tight junction of hepatocytes and immune function [5–7,16,17].
Approach to the Patient Who Has Suspected Acute Bacterial Cholangitis
2006, Gastroenterology Clinics of North AmericaCitation Excerpt :In most settings of acute cholangitis it is unclear exactly how bacteria enter an obstructed biliary. Some studies showed that the incidence of bacteremia or appearance of endotoxemia was related directly to the pressure within the biliary system [18–22]. Recent research has demonstrated that biliary obstruction is associated with increased intestinal permeability and disruption of intestinal integrity, which leads to an increased likelihood that bacteria enter the blood or lymphatic system [23–25].
Paper presented at the 2nd World Congress of the IHPBA, Bologna, Italy, June 2–6, 1996.
McSween, R. N. M.Anthony, P. P.Scheuer, P. J.