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Bile Infarcts: New Insights Into the Pathogenesis of Obstructive Cholestasis

Bile infarcts were first accurately described in 1876 by Charcot and Gombault in studies in animals after bile duct ligation. Since that time, the cause of these infarcts known as "Charcot-Gombault necrosis" has been widely debated. Modern hypotheses first suggested that the accumulation of bile acids in hepatocytes is directly responsible for hepatocyte death due to their cytotoxic detergent properties. Subsequent studies suggested that bile acids cause hepatocyte apoptosis. Currently it is believed that bile acids injure hepatocytes not by their detergent properties but by triggering a cytokine-mediated inflammatory response. Although considerable evidence now supports this latter hypothesis (1-3), the sequence of events that lead to bile infarcts and hepatocyte necrosis after BDL remains to be elucidated. This article is protected by copyright. All rights reserved.