Veerankutty Fadl H, Sengupta Kushan, Vij Mukul, Rammohan Ashwin, Jothimani Dinesh, Murali Ananthavadivelu, Rela Mohamed
Institute of Liver Disease and Transplantation, Dr. Rela Institute and Research Centre, Chennai 600044, India.
Institute of Liver Disease and Transplantation, Dr. Rela Institute and Medical Centre, Chennai 600044, India.
World J Gastrointest Surg. 2023 May 27;15(5):788-798. doi: 10.4240/wjgs.v15.i5.788.
Post-coronavirus disease 2019 (COVID-19) cholangiopathy (PCC) is a rare but life-threatening complication of COVID-19 infection. PCC typically presents when patients recovering from the contagion and manifests as cholestasis in patients with no history of pre-existing liver disease. The pathogenesis of PCC is little understood. Hepatic injury in PCC could be mediated by the predilection of severe acute respiratory syndrome coronavirus 2 for cholangiocytes. Though PCC shows some resemblance to secondary sclerosing cholangitis in critically ill patients, it is considered as a separate and unique entity in the literature. Various treatment options like ursodeoxycholic acid, steroids, plasmapheresis, and endoscopic retrograde cholangiopancreatography guided interventions have been tried but with limited success. We have noticed significant improvement in liver function with antiplatelet therapy in a couple of patients. PCC can progress to end-stage liver disease necessitating liver transplantation. In this article, we discuss the current knowledge of PCC focusing on its pathophysiology, clinical manifestations, and management strategies.
2019冠状病毒病（COVID-19）后胆管病（PCC）是COVID-19感染一种罕见但危及生命的并发症。PCC通常在患者从传染病中康复时出现，表现为既往无肝病病史患者的胆汁淤积。PCC的发病机制尚不清楚。PCC中的肝损伤可能由严重急性呼吸综合征冠状病毒2对胆管细胞的偏好介导。尽管PCC在危重症患者中与继发性硬化性胆管炎有一些相似之处，但在文献中它被认为是一个独立且独特的实体。已经尝试了各种治疗方案，如熊去氧胆酸、类固醇、血浆置换以及内镜逆行胰胆管造影引导下的干预措施，但取得的成功有限。我们注意到在一些患者中抗血小板治疗使肝功能有显著改善。PCC可进展为终末期肝病，需要进行肝移植。在本文中，我们讨论了PCC的当前知识，重点关注其病理生理学、临床表现和管理策略。
