Studies on intestinal motility and mechanism of cholangitis after biliary reconstruction

Cholangitis is a serious complication of biliary reconstruction for congenital biliary atresia. To observe the effect of intestinal motility on the mechanism of cholangitis, we studied intestinal motility in dogs after experimental common duct ligation and reconstruction by Roux-en-Y or interposition cholecystojejunostomy. One year after operation, bipolar electrodes were implanted in the canine intestine and electromyograms were performed. Distinct patterns of propagation and the direction of intestinal motility characteristic of each procedure were observed. The animals with Roux-en-Y loops showed a decrease in motility of the duodenum and upper jejunum. Those with an interposed segment demonstrated stagnation in both the duodenum and jejunum, and poor coordination of intestinal movement. The myoelectric activity of the Roux-en-Y loop suggests that it is the reconstruction technique most likely to prevent reflux cholangitis.