Biliary bacteria and hepatic histopathologic changes in gallstone disease.

This study attempts to assess the frequency and severity of liver damage in patients with gallstone disease and the role of bacteria in the development of these changes. Needle biopsy of the liver demonstrated acute inflammation of portal triads in 19 of 126 patients with gallstones, a finding not present in control patients. Acute inflammation occurred more often in patients with acute cholecystitis and choledocholithiasis than in chronic cholecystitis. Cultures of the biliary tract or liver were positive in 23 of 64 patients. The frequency of positive bile cultures increased with the severity of the biliary tract disease. Five out of 6 positive liver cultures were from patients with acute cholecystitis or choledocholithiasis. The data suggest that impairment of bile flow is responsible for the acute hepatic inflammatory changes.