Merck Manual

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Ischemic Cholangiopathy


Whitney Jackson

, MD, University of Colorado School of Medicine

Reviewed/Revised Jan 2022 | Modified Sep 2022
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Ischemic cholangiopathy is focal damage to the biliary tree due to disrupted flow from the hepatic artery via the peribiliary arterial plexus.

Etiology of Ischemic Cholangiopathy

Common causes of ischemic cholangiopathy include

  • Vascular injury during orthotopic liver transplantation or laparoscopic cholecystectomy

  • Graft-rejection injury

  • Chemoembolization

  • Radiation therapy

  • Thrombosis resulting from hypercoagulability disorders

Symptoms and Signs of Ischemic Cholangiopathy

Symptoms (eg, pruritus, dark urine, pale stools) and results of laboratory tests and imaging studies may indicate cholestasis.

Diagnosis of Ischemic Cholangiopathy

Treatment of Ischemic Cholangiopathy

  • For rejection, antirejection therapy and possibly retransplantation

  • For biliary strictures, balloon dilation and stenting

Treatment is directed at the cause. After liver transplantation Liver Transplantation Liver transplantation is the 2nd most common type of solid organ transplantation. (See also Overview of Transplantation.) Indications for liver transplantation include Cirrhosis (70% of transplantations... read more , such treatment includes antirejection therapy and possible retransplantation. Biliary strictures warrant endoscopic balloon dilation and stenting.

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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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