Hepatectomy or Bile-Duct Ligation Increases Bacterial Translocation to the Liver in a Murine Model

Abstract

Introduction: The therapeutic potential of microbiota is intensively studied. Studies show that the use of probiotics may shorten postoperative length of stay and enhance post-hepatectomy liver regeneration. The use of microbiota in the perioperative period in conjuction with conditions that jeopardize intestinal mucosal integrity, such as bile duct obstruction, antibiotic or chemotherapy treatment, must raise concerns regarding the potential risk of microbiota related infection. Our aim was to assess the rate of translocation of intragastric administered bacteria to the liver parenchyma in mice after chemotherapy administration, partial hepatectomy (PH), antibiotic treatment, and bile duct ligation (BDL). Methods: The murine model began with one of the following interventions: intraperitoneal 5-FU administration, 70% PH, antibiotic administration, or BDL. Control was "sham" laparotomy and naïve mice. Mice received stained microbiota (SM) by intragastric administration and 1-2 hours later were sacrificed. Translocation of the administered stained microbiota to the liver was identified using flow cytometry or in vivo imaging system (IVIS). Results: BDL and PH were associated with significantly higher hepatic accumulation of SM compared with control (443±49 vs 31±10 events). IVIS demonstrated rapid translocation of intragastric-administered SM in mice following PH and BDL, compared with control. Antibiotic or chemotherapy were not associated with increase in bacterial translocation. Conclusions: In a mural model, PH or BDL were associated with increased bacterial translocation. These findings shed light on the pathophysiology of cholangitis, the perioperative period of post hepatectomy, and accentuate the concerns regarding the risks of microbiota administration in the perioperative period.