Is Bile a Source of Infection in Acute Pancreatitis?

Abstract

Infection of bile is one of the consequences of acute cholecystitis and bile duct obstruction. Its contribution to infection of pancreatic necrosis, despite its theoretical relevance, remains unclear. However, biliary obstruction leads to both increased bacterial translocation and reticuloendothelial system dysfunction resulting in a net increase in circulating bacteria and endotoxin. It is via this indirect mechanism that bile, infected or not, may contribute most to the infectious processes in acute pancreatitis.

Infective Complications after Abdominal Surgery in Patients Infected with Human Immunodeficiency Virus: Role of CD4+ Lymphocytes in Prognosis

“…Patients with surgical procedures related to the biliary tree have an increased incidence of wound infections unrelated to the low levels of CD4 lymphocytes. As previously noted by Senninger [14], biliary obstruction leads to increased endotoxin levels in the portal venous blood, reduced bowel motility, and increased bacterial translocation. It has been clearly shown experimentally that reticuloendothelial system activity deteriorates early after biliary obstruction.…”