Biliary Cast Successfully Removed by Percutaneous Transhepatic Cholangioscopy, and This Developed in a Patient Who Received Orthotopic Liver Transplantation

Korean J Gastrointest Endosc > Volume 33(6); 2006 > Article

Korean Journal of Gastrointestinal Endoscopy 2006;33(6): 381-384.

경피 경간 담도경술을 통해 성공적으로 제거된 간이식 후 합병된 Biliary Cast

김홍정·윤기태·방승민·박승우·송시영·정재복

연세대학교 의과대학 내과학교실, 소화기내과, 소화기병연구소

Biliary Cast Successfully Removed by Percutaneous Transhepatic Cholangioscopy, and This Developed in a Patient Who Received Orthotopic Liver Transplantation

Hong Jeoung Kim, M.D., Ki Tae Yoon, M.D., Seungmin Bang, M.D., Seung Woo Park, M.D., Si Young Song, M.D. and Jae Bock Chung, M.D.

Division of Gastroenterology, Institute of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

Abstract

"Biliary cast syndrome" describes a cast formed from retained lithogenic material, and this cast is morphologically confined to the bile duct; this develops in 4∼18% of liver transplant recipients. The pathogenesis of cast formation is not clearly understood. The proposing etiological factors for biliary cast syndrome include acute cellular rejection, a prolonged cold ischemic time, use of postoperative biliary drainage tubes and biliary infection. These casts are more likely to develop in the setting of hepatic ischemia and biliary stricture. Endoscopic and percutaneous cast extraction might achieve favorable results and this should be attempted before surgical therapy. We report here on a case of biliary cast syndrome that was secondary to orthotopic liver transplantation; this was successfully treated via percutaneous choledochoscopic removal. We also include a review of the literature. (Korean J Gastrointest Endosc 2006;33:381⁣384)

Key Words: Billiary cast syndrome, Biliary cast, Post liver transplantation complication

주요어: Biliary cast syndrome, Biliary cast, 간이식 후 합병증