Open AccessProlonged cholestasis following endoscopic retrograde cholangiopancreatography, a rare complication of contrast agent induced liver injury
Author(s) -
ChengKuan Lin,
Wen Ching Huang
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000018855
Subject(s) - medicine , cholestasis , endoscopic retrograde cholangiopancreatography , ursodeoxycholic acid , gastroenterology , complication , cholestyramine , bilirubin , jaundice , bile duct , liver biopsy , liver injury , percutaneous transhepatic cholangiography , surgery , biopsy , cholangiography , cholesterol , pancreatitis
Abstract Rationale: Prolonged cholestasis is a rare complication associated with endoscopic retrograde cholangiopancreatography (ERCP). Patient concerns: A 68-year-old man who presented with worsening cholestasis after ERCP for the removal of a common bile duct stone. Diagnosis: Total bilirubin increased up to 35.2 mg/dL after the 21st day post-ERCP. A percutaneous liver biopsy was performed and drug-related cholestasis was suspected as occurring as a result of the contrast agent. Interventions: Oral ursodeoxycholic acid and cholestyramine were prescribed to the patient. Outcomes: By the 7th week post-ERCP, the patient's symptoms and markers of physiological health began to resolve. The bilirubin returned to normal levels on the 106th day post-ERCP. We reviewed the literature for studies of 9 patients with jaundice more than 30 days post-ERCP, the peak of total serum bilirubin occurred on 16th ± 7th days and the recovery followed after mean time of 54th ± 22th days. Lessons: Although the cholestasis was prolonged, the outcome was favorable after medical therapy. There were no long-term consequences for the patient.