Are there inflammatory changes in the hepatic biopsies of patients with acute cholangitis of lithiasic origin?

Introduction: Acute cholangitis (AC) is a clinical diagnosis entity. A high prevalence of acute inflammatory changes (AIC) are found in hepatic needle biopsies (HB) in these patients. The aim of our study is to determine the prevalence of AIC in HB performed on patients with AC due to biliary stones. Methods: Cross-sectional study. Surgery was performed at the Hospital Regional of Temuco. Patients with Charcot’s triad, over 15 years of age, and surgical exploration of common bile duct were included. There was exclusion if periampullary tumor or liver cirrhosis was suspected. Bile macroscopy and hepatic histopathology were determined. A hepatic needle biopsy was taken during surgery. Biopsies were analyzed by two independent pathologist groups and kappa statistics were applied. Results: From January to June, 2002, fifty-three patients (83% female) with a median age of 60.7 years with AC were operated on. We found 83% with pus in the biliary system and 17% with cloudy bile. Histopathology: minimal changes (32%), hepatic steatosis (25%), chronic periportal infiltration (17%), liver cirrhosis (11%), AIC (6%) and normal (9%). Kappa statistics were 0.77. In conclusion a low prevalence of AIC was found in the HB of patients with AC.