Ischemic cholangiopathy
Last reviewed: 23.04.2024
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[Causes of ischemic cholangiopathy
The main causes of ischemic cholangiopathy include orthotopic liver transplantation (hepatic artery thrombosis or periabilial plexus lesions during graft rejection reaction), chemoembolization, radiation therapy, iatrogenic hepatic artery damage or ligation in laparoscopic cholecystectomy and thrombosis due to hypercoagulability syndrome. As a result, cholestasis develops, sometimes with biliary duct necrosis, cholangitis or stricture of the biliary tract.
Symptoms of ischemic cholangiopathy
Symptomatic data of laboratory and instrumental studies demonstrate cholestasis. If there is a suspicion of ischemia, functional liver tests and ultrasonography (often with a negative result) are performed. If chances of ischemic cholangiopathy after orthotopic liver transplantation, cholangiography with MRI or endoscopy is performed. If the cause of the disease is transplantation, multiple strictures can 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 dilatation of biliary strictures or re-transplantation.