Relationship Between Ischemic Bile Duct Injury And Liver Abscess: An Experimental Study

Background. Liver abscesses after hepatic artery ligation or resection have been reported anecdotally. The biliary tract is considered to be the Achilles'heel of the liver, which is exclusively supplied by a network of arterioles and capillaries stemming from the hepatic arterial branches. Ischemic bile duct injury induced by hepatic arterial insufficiency may play an important role in the development of liver abscess. The aim of this study was to determine whether breakdown of intrahepatic bile ducts induced by arterial ischemia contributes to the development of liver abscess.Materials and Methods. Male Sprague-Dawley rats were surgically subjected to partial or complete hepatic arterial deprivation. Escherichia coli injected into the common bile duct was used to mimic bacterial translocation. After 14 days, serum biochemical analysis was performed, and ischemic injury of the liver was evaluated by histological examination.Results. Biochemical signs of hepatobiliary damage were detected in animals after complete hepatic arterial deprivation. Bilomas secondary to hepatobiliary necrosis and bile extravasation were observed exclusively in these rats. After intrabiliary Escherichia coli infection, infected bilomas give rise to liver abscesses in completely dearterialized rat livers. While bilomas and liver abscesses were not found in rats with partial hepatic arterial deprivation or a sham operation.Conclusions. Complete arterial deprivation of the rat liver leads to biloma formation, which can evolve into liver abscess after infection.