Biliary Atresia Associated Cholangitis – The Central Role and Effective Management of Bile Lakes

Objectives: Cholangitis and bile lakes are incompletely understood complications after portoenterostomy (PE). We investigated relationships between recurrent cholangitis, bile lakes and clinical outcomes as well as surgical management of bile lakes. Methods: In this retrospective observational single institution study medical records and imaging studies of all patients who had undergone PE for biliary atresia during 1987–2016 (N = 61) were reviewed. We related occurrence of cholangitis episodes with the presence of intrahepatic bile lakes, patient characteristics, and PE outcomes. Risk factors for recurrent cholangitis and bile lakes, and management of bile lakes were analysed. Results: Despite routine antibiotic prophylaxis median of 3.0 cholangitis episodes (0.75 episodes/year) occurred in 48 (79%) patients. Intrahepatic bile lakes were discovered in 8 (13%) patients by 16 months after PE. Overall, 54% had survived with their native liver at median age of 7.3 years and 28 (46%) patients had ≥1 cholangitis episodes/year. Number and frequency of cholangitis episodes were >5 times higher among patients with bile lakes (P 

from Gastroenterology via xlomafota13 on Inoreader http://bit.ly/2RDzlvO
via IFTTT