What causes cholangitis?

Cholangitis is a common liver and gallbladder disease that is quite harmful to patients. There are many causes of cholangitis, and there are many different opinions in medicine. There is no scientific conclusion. Many medical experts believe that cholangitis is mainly a congenital disease, while others believe that it is a disease caused by acquired factors. At present, cholangitis is related to viral infection and congenital developmental abnormalities.

What causes cholangitis?

1. Viral infection theory

It is believed that biliary atresia, neonatal hepatitis and bile duct dilatation are a common cause and are the result of inflammatory infection of the hepatobiliary system. Following viral infection, giant cell degeneration occurs in the liver and the bile duct epithelium is damaged, resulting in ductal obstruction (biliary atresia) or weakening of the bile duct wall (biliary dilatation). But the number of people supporting this view has decreased.

2. Congenital anomaly theory

It is believed that during embryonic development, primitive bile duct cells proliferate into a cord-like entity, which then gradually cavitates and penetrates. If a part of the epithelial cells proliferates excessively, excessive cavitation will occur during cavitation recanalization, resulting in expansion.

Some scholars believe that the formation of bile duct dilatation requires the participation of both congenital and acquired factors. The weak development of the bile duct wall caused by excessive proliferation and excessive cavitation of bile duct epithelial cells during the embryonic period is a congenital factor. Combined with acquired factors, such as obstruction of the terminal common bile duct secondary to pancreatitis or ampullary inflammation and the resulting increase in intra-bile duct pressure, will eventually lead to bile duct dilatation.

(III) Pancreaticobiliary duct junction normal conduction theory

It is believed that because the common bile duct and the main pancreatic duct fail to separate normally during the embryonic period, the junction between the two is far away from the ampulla of Vater, resulting in a common channel of the pancreaticobiliary duct that is too long, and the main pancreatic duct and the common bile duct intersect at an almost right angle. Therefore, the site of the pancreaticobiliary anastomosis is not at the duodenal papilla, but outside the duodenum wall. There is no sphincter in the local area, thus losing its sphincter function, causing the pancreatic juice and bile to reflux each other. When pancreatic fluid is secreted excessively and the pressure increases, the bile duct dilates. In recent years, retrograde pancreaticobiliary angiography has confirmed that the rate of pancreaticobiliary confluence is as high as 90% to 100%, and the fact that the amylase content in the dilated bile duct is increased has been found. Animal experiments have shown that after pancreatic juice enters the bile duct, the activities of amylase, trypsin, and elastase increase, which may be the main cause of bile duct damage.