Plasmapheresis and corticosteroid treatment for persistent jaundice after successful drainage of common bile duct stones by endoscopic retrograde cholangiography
Ulku Saritas, Bunyamin Aydin, Y Ustundag
article (Uluslararası, Hakemli) | Yazar(lar): Ulku Saritas, Bunyamin Aydin, Y Ustundag | Yıl: 2007 | Dergi/Kurum: WORLD JOURNAL OF GASTROENTEROLOGY | İndeks: WOS.SCI | Anahtar Kelimeler: endoscopic retrograde cholangiography, cholestasis, plasmapheresis — Özet: Prolonged cholestasis is a very rare complication of endos
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. (c) 2007 WJG. All rights reserved.