{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T22:04:17Z","timestamp":1793311457010,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T00:00:00Z","timestamp":1617667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We re\u2010analyzed data on cholangio\u2010venous reflux from a clinical study conducted prospectively on 22 patients in 1974.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Direct cholangiography was performed with indocyanine green (ICG) mixed into Urographin<jats:sup>R<\/jats:sup> under monitoring of intrabiliary pressure, and the participants were allocated to three groups according to whether ICG leakage into the blood, signs of infection, or both, were present.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The intrabiliary pressure of six patients negative for both ICG leakage and signs of infection was approximately 19.5 (median, [range 18\u201022])\u00a0cmH<jats:sub>2<\/jats:sub>O. In contrast, for the five patients positive for ICG leakage but negative for signs of infection, the intrabiliary pressure was higher (median 32.0 [range 27\u201041)\u00a0cmH<jats:sub>2<\/jats:sub>O]. The 11 patients positive for both ICG leakage and signs of infection had the highest intrabiliary pressure (median 48.0 [range 33\u201077]\u00a0cmH<jats:sub>2<\/jats:sub>O). Our analyses revealed that, as the intrabiliary pressure increased, the status of ICG leakage and signs of infection appeared in a stepwise fashion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings suggest that the tight junctions sealing the bile canaliculi deteriorated with increasing intrabiliary pressure, resulting in reflux of the biliary contents into the vascular system via paracellular pathways between hepatocytes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.937","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T13:01:52Z","timestamp":1615813312000},"page":"508-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cholangio\u2010venous reflux of biliary contents through paracellular pathways between hepatocytes in patients with acute cholangitis"],"prefix":"10.1002","volume":"28","author":[{"given":"Tadahiro","family":"Takada","sequence":"first","affiliation":[{"name":"Department of Surgery Teikyo University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Takikawa","sequence":"additional","affiliation":[{"name":"Department of Medicine Teikyo University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norimasa","family":"Sawada","sequence":"additional","affiliation":[{"name":"Second Department of Pathology Sapporo Medical University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2423-4154","authenticated-orcid":false,"given":"Ryota","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Department of Surgery Institute of Gastroenterology Tokyo Women\u2019s Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Nagamachi","sequence":"additional","affiliation":[{"name":"Department of Medicine Teikyo University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Isaji","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic Surgery and Transplantation Mie University Mie Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Pancreatic and Gastrointestinal Surgery School of Medicine International University of Health and Welfare Ichikawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakazu","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Surgery Institute of Gastroenterology Tokyo Women\u2019s Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1969.01340110121014"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI104072"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2957\/kanzo.5.114"},{"key":"e_1_2_7_5_1","first-page":"1137","article-title":"Clinical verification of bile\u2010blood fistula in acute biliary infection","author":"Takada T","year":"1976","journal-title":"Jpn J Gastroenterol Surg"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.5833\/jjgs.20.2350"},{"issue":"1","key":"e_1_2_7_7_1","first-page":"91","article-title":"The significance of biliary regurgitation in severe cholangitis","volume":"18","author":"Takada T","year":"1989","journal-title":"KAN\u2010TAN\u2010SUI"},{"key":"e_1_2_7_8_1","first-page":"933","article-title":"Looking back at the mechanism of regurgitation of substances in bile into the blood","volume":"6","author":"Takada T","year":"2020","journal-title":"Kan\u2010Tan\u2010Sui"},{"key":"e_1_2_7_9_1","unstructured":"TakadaT HanyuF KobayashiS MikoshibaY HamanoK.Percutaneous transhepatic cholangiodrainage and cholangioscopy for the cases of obstructive jaundice caused by pancreatic tumor. 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