Electromyographic study of the mechanism of postoperative cholangitis in congenital biliary atresia

Cholangitis after biliary reconstruction for congenital biliary atresia is a troublesome postoperative complication. In order to clarify its mechanism and the changes in intestinal movement after biliary reconstruction by Roux-en-Y anastomosis, we performed electromyographic (EMG) studies of the motility of the reconstructed intestine in dogs. Monitoring the basic electrical rhythm (BER) and migrating myoelectric complexes (MMC), EMG analysis was carried out. As most of the Y-loop MMCs were propagated smoothly to the anal side, according to the continuity of the intestine, the intestinal contents were transported without stagnation. These intestinal movements appear to be useful as a biliary drainage route and to prevent ascending cholangitis. A comparison of short- and long-term intestinal motility after biliary reconstruction showed adaptation of the intestinal movement following the procedure. The outflow of bile appeared to accelerate intestinal motility because of prolongation of the MMC interval in the duodenum and oral jejunum without bile flow. Offprint requests to: M. Yagi