Identification, quantification, and significance of bacterial growth within the biliary tract after Kasai's operation

Cholangitis is a universal complication of successful hepatic portoenterostomy for biliary atresia. In this study 283 bacteriologic cultures were obtained from 19 patients during a 23-mo period. All bilioenteric conduits were colonized with colonic flora by 1 mo after operation. Cholangitis was characterized by fever and a decrease in bilirubin clearance, but not by a change in the number of different types of bacteria nor a change in the total bacteriologic concentration within the conduit. No overall antibiotic effect on the flora could be found. Cholangitis remains a condition that is necessarily treated empirically.