Batts K P
Division of Anatomic Pathology, Mayo Clinic Rochester, Minnesota 55905, USA.
Mayo Clin Proc. 1998 Apr;73(4):380-5. doi: 10.1016/S0025-6196(11)63706-3.
Ischemia-induced bile duct lesions have been collectively labeled as ischemic cholangitis. The biliary epithelium is dependent on arterial blood flow, unlike the hepatic parenchyma with its dual arterial and portal venous blood supply. As such, the biliary epithelium is susceptible to injury when arterial blood flow is compromised. This compromise can occur at the level of the major, named hepatic artery branches or at the microscopic, peribiliary capillary plexus level. Typically, ischemic cholangitis manifests as segmental strictures and cholangiectases with resultant mechanical impairment of bile flow and, occasionally, secondary infection of the biliary system. Ischemic cholangitis after liver transplantation is becoming an important problem and likely is attributable to numerous factors. Hepatic arterial infusion of chemotherapy and systemic vasculitis are other causes of ischemic cholangitis. The role of ischemia in other chronic biliary and ductopenic diseases remains speculative.
缺血性胆管病变被统称为缺血性胆管炎。与具有动脉和门静脉双重血液供应的肝实质不同，胆管上皮依赖动脉血流。因此，当动脉血流受损时，胆管上皮容易受到损伤。这种损伤可发生在主要的、命名的肝动脉分支水平，或在微观的胆管周围毛细血管丛水平。典型的缺血性胆管炎表现为节段性狭窄和胆管扩张，导致胆汁流动的机械性障碍，偶尔还会引发胆道系统的继发感染。肝移植后的缺血性胆管炎正成为一个重要问题，可能归因于多种因素。肝动脉灌注化疗和系统性血管炎是缺血性胆管炎的其他病因。缺血在其他慢性胆管和胆管开放性疾病中的作用仍具有推测性。
