ヒグチ　リヨウタ   HIGUCHI Ryota   樋口　亮太    所属   医学部 医学科（附属八千代医療センター）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Cholangio-venous reflux of biliary contents through paracellular pathways between hepatocytes in patients with acute cholangitis.
掲載誌名	正式名：Journal of hepato-biliary-pancreatic sciences 略　 称：J Hepatobiliary Pancreat Sci ISSNコード：18686982/18686974
掲載区分	国外
巻・号・頁	28(6),pp.508-514
著者・共著者	Takada Tadahiro, Takikawa Hajime, Sawada Norimasa, Higuchi Ryota, Nagamachi Yukiko, Isaji Shuji, Yoshida Masahiro, Yamamoto Masakazu
発行年月	2021/06
概要	BACKGROUND:We re-analyzed data on cholangio-venous reflux from a clinical study conducted prospectively on 22 patients in 1974.METHOD:Direct cholangiography was performed with indocyanine green (ICG) mixed into UrographinR under monitoring of intrabiliary pressure, and the participants were allocated to three groups according to whether ICG leakage into the blood, signs of infection, or both, were present.RESULTS:The intrabiliary pressure of six patients negative for both ICG leakage and signs of infection was approximately 19.5 (median, [range 18-22]) cmH2 O. In contrast, for the five patients positive for ICG leakage but negative for signs of infection, the intrabiliary pressure was higher (median 32.0 [range 27-41) cmH2 O]. The 11 patients positive for both ICG leakage and signs of infection had the highest intrabiliary pressure (median 48.0 [range 33-77] cmH2 O). Our analyses revealed that, as the intrabiliary pressure increased, the status of ICG leakage and signs of infection appeared in a stepwise fashion.CONCLUSION:Our findings suggest that the tight junctions sealing the bile canaliculi deteriorated with increasing intrabiliary pressure, resulting in reflux of the biliary contents into the vascular system via paracellular pathways between hepatocytes.
DOI	10.1002/jhbp.937
PMID	33720522