Current concept about postoperative cholangitis in biliary atresia.
BACKGROUND
Postoperative cholangitis characterized by fever and acholic stool and positive blood culture is a common and serious complication following Kasai's operation for biliary atresia. The aim of this review was to describe the pathogenesis, clinical manifestations, medical treatment and outcome of postoperative cholangitis.


METHODS
Articles on biliary atresia retrieved from Pubmed and MEDLINE in the recent 10 years were reviewed.


RESULTS
The pathogenesis of postoperative cholangitis is still controversial. Recent methods for the diagnosis of postoperative cholangitis include urinary sulfated bile acids (USBA) and magnetic resonance cholangio-pancreaticography (MRCP). High-dose steroids and oral antibiotics have been used to reduce the incidence of postoperative cholangitis, and recurrent cholangitis leads to a lower survival rate.


CONCLUSIONS
Cholangitis is one of the most important determinants of long-term survival after the Kasai's procedure. The knowledge on postoperative cholangitis has been increasing in the past 10 years, showing a lower incidence of the disease and better therapeutic results.
Luo
Yi
Y
Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 200032, China.
Zheng
Shan
S
D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001647:Bile Acids and Salts / Q000652:urine; D001653:Bile Ducts, Intrahepatic / Q000503:physiopathology; D001656:Biliary Atresia / Q000601:surgery*; D049448:Cholangiopancreatography, Magnetic Resonance; D002761:Cholangitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D020347:Lithiasis / Q000150:complications; D008107:Liver Diseases / Q000150:complications; D011171:Portoenterostomy, Hepatic / Q000009:adverse effects* / Q000379:methods
D000900:Anti-Bacterial Agents; D001647:Bile Acids and Salts; D005938:Glucocorticoids