Experimental investigations into the etiology of cholangitis following operation for biliary atresia

Experimental operations carried out on young minipigs appear to show that cholangitis does not occur after simple ligation of the bile duct, but develops nearly invariably is the lymphatic drainage from the liver is also interrupted. The so-called "ascending" cholangitis observed after hepato-porto-entero anastomosis is probably not ascending at all, but blood-borne. When a hepatic portoenterostomy is carried out for biliary atresia, trauma to the lymphatics in the porta hepatis should be avoided and an additional omento-hepato-portopexy should be done. Recent clinical experience appears to confirm this hypothesis.