Sepsis in common serious hepato-biliary disorders: a review article

Assessing hepatobiliary function among critically ill patients remains challenging, and neither static nor dynamic tests can be considered a gold standard. This issue could contribute to an underestimation of the frequency and importance of this system dysfunction during the course of sepsis. Because hepatic and biliary dysfunction is strongly associated with high morbidity and mortality in patients with sepsis, the ability to accurately assess these functions is of critical interest. During sepsis, the liver plays a key role in the pathophysiology of this disorder. It is implicated in the host response, participating in the clearance of the infectious agents and their products. Sepsis also can causes hepatobiliary damage through hemodynamic alterations or through direct or indirect assault on the hepatocytes or through both. Accordingly, hepatobiliary dysfunction induced by sepsis is recognized as one of the components that contribute to the severity of the disease. In this review article, we discuss the epidemiology, diagnostic tools, and some impact on outcome as well as the pathophysiological aspects, including the cellular events and clinical picture leading to hepatobiliary dysfunction. Finally, therapeutic considerations with regard to the weakness of the pertinent specific approach are examined