Ischemic cholangitis caused by transcatheter hepatic arterial chemoembolization 10 months after resection of the extrahepatic bile duct.
We report a case of ischemic cholangitis that occurred after transcatheter hepatic arterial chemoembolization (TAE). Ten months prior to TAE the patient had undergone central bisegmentectomy for hepatocellular carcinoma with resection of the extrahepatic bile duct. Eleven days after TAE, he developed suppurative cholangitis and multiple organ failure. Prior surgical ligation of the peribiliary arteries around the extrahepatic bile duct followed by TAE was considered to have played a crucial role in the development of ischemic cholangitis. This case demonstrates the importance of blood flow from the peribiliary arteries for the survival of the biliary epithelium.
Hasegawa
K
K
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo and Tokyo University Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Kubota
K
K
Aoki
T
T
Hirai
I
I
Miyazawa
M
M
Ohtomo
K
K
Makuuchi
M
M
D000792:Angiography; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D017734:Bile Ducts, Extrahepatic / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000098:blood supply*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D002761:Cholangitis / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D006499:Hepatic Artery; D006801:Humans; D007269:Injections, Intra-Arterial; D007511:Ischemia / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D013396:Suction; D014057:Tomography, X-Ray Computed