Korean J Gastrointest Endosc.  2006 Dec;33(6):381-384.

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

• Kim HJ
• Yoon KT
• Bang S
• Park SW
• Song SY
• Chung JB

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.

Keyword

Billiary cast syndrome; Biliary cast; Post

MeSH Terms

Bile Ducts
Cold Ischemia
Constriction, Pathologic
Drainage
Humans
Ischemia
Liver Transplantation*
Liver*
Superior Mesenteric Artery Syndrome
Transplantation