Linkage of persistent cholangitis after bilioenterostomy with biliary carcinogenesis in hamsters

Biliary carcinoma occurring after bilioenterostomy has been reported as a l ate complication of this surgical procedure. The present study was designed to determine if bilioenterostomy promotes biliary carcinogenesis, and also to clarify the relationship between biliary inflammation and biliary carci nogenesis in hamsters. Syrian hamsters underwent a simple laparotomy (SL), choledochoduodenostomy (CD) or choledochojejunostomy (CJ). All hamsters rec eived subcutaneous injections of the chemical carcinogen, N-nitrosobis (2-o xopropyl) amine (BOP), and were sacrificed 20 weeks after surgery. Neoplast ic lesions in the biliary tree were histologically examined, and the presen ce and degree of cholangitis was also evaluated with special reference to b iliary carcinogenesis. The incidence of bile duct carcinoma was not signifi cantly different among the three groups. Numerous bile duct carcinomas, how ever, were recognized in the bilioenterostomized animals, especially in the CJ group. Moreover, significant correlations between biliary carcinogenesi s and the presence of cholangitis were noted in both the CD and CJ groups, but not in the SL control group. Severe cholangitis was evident in the CJ g roup, and the number of biliary carcinomas was well correlated with the deg ree of cholangitis. In conclusion, the risk of carcinoma in the biliary tra ct may increase when persistent cholangitis is present after biliary recons truction.