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Ischemic cholangiopathy
Last reviewed: 04.07.2025
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[ Causes of ischemic cholangiopathy
The main causes of ischemic cholangiopathy include orthotopic liver transplantation (hepatic artery thrombosis or peribiliary plexus injury due to graft rejection), chemoembolization, radiation therapy, iatrogenic hepatic artery injury or ligation during laparoscopic cholecystectomy, and thrombosis due to hypercoagulability syndrome. The result is cholestasis, sometimes with biliary duct necrosis, cholangitis, or biliary strictures.
Symptoms of ischemic cholangiopathy
Symptoms, laboratory and instrumental examination data demonstrate cholestasis. If ischemia is suspected, liver function tests and ultrasonography (often with a negative result) are performed. If ischemic cholangiopathy is suspected after orthotopic liver transplantation, cholangiography with MRI or endoscopy is performed. If the cause of the disease is transplantation, multiple strictures may develop.
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Treatment of ischemic cholangiopathy
Treatment of ischemic cholangiopathy is aimed at eliminating the cause. After liver transplantation, treatment includes immunosuppressive therapy and possibly endoscopic balloon dilation of biliary strictures or retransplantation.