Ascending infection of the biliary tract after surgical sphincterotomy and biliary stenting

J. Y. Sung, Joseph Leung, E. A. Shaffer, K. Lam, M. E. Olson, J. W. Costerton

Research output: Contribution to journalArticlepeer-review

100 Scopus citations


It has been widely accepted that there is an ascending route of bacterial infection of the biliary tract but there is a lack of direct evidence. This hypothesis was tested in an animal experiment using the cat as an animal model. The implantation of biliary stents and surgical sphincterotomy were performed in these animals, with sham controls. Stents bypassing the sphincter of Oddi with the tip in the duodenal lumen were colonized by duodenal micro-organisms and the biliary tract was heavily contaminated. Blockage of these stents resulted in biliary obstruction. Stents implanted within the common bile duct, proximal to the sphincter were largely unaffected by biofilm formation. After surgical sphincterotomy the biliary tract was also contaminated but, in the absence of obstruction, the animals did not develop any symptoms. It was concluded that ascending infection by duodenal biliary reflux, via the sphincter of Oddi, is an important route of infection in the biliary system.

Original languageEnglish (US)
Pages (from-to)240-245
Number of pages6
JournalJournal of gastroenterology and hepatology
Issue number3
StatePublished - 1992
Externally publishedYes

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology


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