Plasmapheresis and corticosteroid treatment for persistent jaundice after successful drainage of common bile duct stones by endoscopic retrograde cholangiography

Saritas U., Aydin B., Ustundag Y.

World Journal of Gastroenterology, vol.13, no.30, pp.4152-4153, 2007 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 13 Issue: 30
  • Publication Date: 2007
  • Doi Number: 10.3748/wjg.v13.i30.4152
  • Journal Name: World Journal of Gastroenterology
  • Journal Indexes: Scopus
  • Page Numbers: pp.4152-4153
  • Keywords: Cholestasis, Endoscopic retrogade cholangiography, Plasmapheresis
  • Kütahya Health Sciences University Affiliated: No

Abstract

Prolonged cholestasis is a very rare complication of endoscopic retrograde cholangiography (ERC). Only few cases with this complication are reported in the English literature. We report persisting cholestatic jaundice in a 73-year old man after successful therapeutic ERC for choledocholithiasis. Serologic tests for viral and autoimmune hepatitis were all negative. A second-look ERC was normal also. He denied any medication except for prophylaxis given intravenous 1 g ceftriaxon prior to the ERC procedure. After an unsuccessful trial with ursodeoxycholic acid and cholestyramine for 2 wk, this case was efficiently treated with corticosteroids and plasmapheresis. His cholestatic enzymes became normal and intense pruritis quickly resolved after this treatment which lasted during his follow-up period. We discussed the possible mechanisms and treatment alternatives of intrahepatic cholestasis associated with the ERC procedure. © 2007 WJG. All rights reserved.