Carrel et al identified risk factors for a pyogenic abscess developing in a patient who has had biliary tract surgery. The authors are from the University Hospital Bern in Switzerland.
Risk factors associated with obstructed bile flow:
(1) stricture (benign or malignant)
(2) foreign body (stent, suture, etc)
(3) stone disease (common bile duct, intrahepatic)
(4) excluded bile-duct segment
Other risk factors:
(1) accidental vascular injury to the hepatic artery during surgery (ligation, etc) with ischemic liver injury
(2) accidental vascular injury to the portal vein during surgery with ischemic liver disease
(3) altered gastrointestinal flora
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