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Semin Liver Dis 2008; 28(3): 235-246
DOI: 10.1055/s-0028-1085092
© Thieme Medical Publishers

Ischemic Cholangiopathy

Pierre Deltenre1 , 2 , Dominique-Charles Valla3
  • 1Service d'Hépato-Gastroentérologie, Hôpital de Jolimont, Haine-Saint-Paul, Belgium
  • 2Service d'Hépato-Gastroentérologie, Hôpital Huriez, CHRU Lille, France
  • 3Service d'Hépatologie, Hôpital Beaujon, Clichy, France
Further Information

Publication History

Publication Date:
23 September 2008 (online)

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ABSTRACT

Bile ducts are supplied with blood exclusively via hepatic arteries. Obstruction of large arteries is rapidly compensated for by the opening of preexisting intrahepatic or transcapsular collateral arteries, which prevents ischemic damage. Ischemic bile duct injury may occur when small hepatic arteries or the peribiliary vascular plexus are injured, or when all possible arterial blood supplies are interrupted, as is the case in transplanted liver with hepatic artery thrombosis. Most causes of bile duct ischemia are iatrogenic. Systemic diseases involving small hepatic arteries may also be implicated. Depending on the extent and velocity of the arterial obstructive process, ischemic cholangiopathy may present as acute formation of biliary casts, bile duct necrosis, or chronic disease resembling primary sclerosing cholangitis. In many patients, correction of arterial obstruction is not possible. When biliary drainage or reconstruction is not possible or has failed, liver transplantation is the only means of providing potential cure.

KEYWORDS

Ischemic cholangitis - peribiliary plexus - hepatic artery thrombosis - liver transplantation - hereditary hemorrhagic telangiectasia

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Dominique-Charles VallaM.D. 

Service d'Hépatologie, Hôpital Beaujon

100, Boulevard du Général Leclerc, 92118 Clichy Cedex, France

Email: dominique.valla@bjn.ap-hop-paris.fr

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