Liver transplantation for a renal transplantation recipient with secondary sclerosing cholangitis by choledochoduodenal fistula

Autor: Wen-Tsan Chang, Niang-Cheng Lin, Cheng-Yuan Hsia, Chin-Su Liu, Hsin-Lin Tsai, Che-Chuan Loong
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Zdroj: Asian Journal of Surgery, Vol 35, Iss 1, Pp 49-52 (2012)
Druh dokumentu: article
ISSN: 1015-9584
DOI: 10.1016/j.asjsur.2012.04.008
Popis: Choledochoduodenal fistula (CDF) complicated by peptic diseases or following surgical or endoscopic approaches of the common bile duct is not uncommon. However, it usually occurs without significant symptoms and can be well controlled with conservative treatment in normal immunized patients. Here we report a case involving a 58-year-old male patient with diabetic nephropathy, who received a choledocholithotomy for choledocholithiasis in November 2007 and renal transplantation in March 2008. The patient had recurring cholangitis during the 5 months following his renal transplantation. Cholangiography and liver biopsy revealed sclerosing cholangitis. The patient underwent liver transplantation (LT) in May 2009 because radiological and endoscopic procedures failed to control his jaundice. A proximal CDF was found during the LT procedures. We considered that the patient's advanced secondary sclerosing cholangitis was induced by this fistula. At the 16 months' follow-up, the patient was surviving well and the graft remained intact. To our knowledge, this is the first report of a renal transplantation recipient receiving LT because of uncontrolled cholangitis caused by a CDF.
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