Ischämische Cholangiopathie bei  nicht lebertransplantierten Patienten – eine retrospektive Analyse bei Patienten der UMG

Ischämische Cholangiopathie bei nicht lebertransplantierten Patienten – eine retrospektive Analyse bei Patienten der UMG

Ischemic Cholangiopathy at not liver transplant patients – a retrospective analysis of patients of the University Medical Center Göttingen

Ardian Mekolli

Doctoral thesis

Date of Examination: 2016-01-20

Date of issue: 2016-03-17

Advisor: Schwörer, Harald Prof. Dr.

Referee: Krause, Petra, PD Dr.

Referee: Schön, Margarete Prof. Dr.

Persistent Address: http://hdl.handle.net/11858/00-1735-0000-0028-8702-0

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Abstract

English

Sclerosing cholangitis in critically ill patients is a form of secondary sclerosing cholangitis in patients with life-threatening diseases requiring an intensive care treatment. This is relatively new and less known disease with unknown pathogenesis. Hypoxic processes of the bilary epithelium are discussed in the literature to play a role as a trigger mechanism of the disease. 51 patients have been diagnosed with Sclerosing cholangitis in critically ill patients (SC-CIP) between the years 04/2007-05/2015 at the University Medical Centre Göttingen. It concerned patient different ages, mostly male. The observation of laboratory parameters in the time frame of 42 days showed a pronounced elevation especially of the cholestatic parameters: ɣ-GT and total bilirubin. The mean Haemoglobin values were normal on the first day of admission on the intensive care unit. From the second day and also in the further course of the observation the patients showed throughout anaemic Median Hb values between 8-9 g/dl. The majority of the patients were diagnosed by ERC. ERC proved to be the most effective diagnostic method in our population. In our opinion, the importance of anaemia should be taken into consideration and further explored in particular with regard to the suspected hypoxic genesis of the disease.

Keywords: ischemic cholangiopathy; secondary sclerosing cholangitis in critically ill patients; bilary cast syndrome