Ischemic type biliary lesions

Last revised by Rohit Sharma on 23 Apr 2020

Ischemic type biliary lesions (ITBL) is a term used to describe non-anastomotic intra- or extrahepatic bile duct strictures after primarily successful liver transplantation, when there is no evidence of perfusion restriction or other cause of bile duct damage (i.e organ rejection or recurrence of primary sclerosing cholangitis1,3.

It should be differentiated from ischemic biliary lesions (IBL) due to vascular complications of operation or intervention and strictures after prolongated ischemia, i.e. hepatic artery stenosis 1.

Radiographic features

Endoscopic retrograde cholangiography and percutaneous transhepatic cholangiography are seen as the gold standard in the diagnosis of ITBL 2. However, MRCP can be used to detect ischemic type biliary lesions and differentiate them from other biliary complications 3-5.

Imaging features are similar to other types of bile duct strictures, including intra- and extrahepatic bile duct stenosis with proximal dilatation.

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