Skip to main content
SpringerLink
Log in

Vascular Supply of the Bile Duct and Ischemic Cholangiopathy

  • Chapter
  • First Online:
Pathology of the Bile Duct

Abstract

The biliary tree is exclusively supplied by the hepatic artery, so hepatic arterial insufficiency and also the damages to the hepatic arteries and their branches including peribiliary vascular plexus (PVP) give rise to various forms of ischemic biliary damages (ischemic cholangiopathies). Ischemic cholangiopathies are composed of several clinicopathological categories such as bile duct necrosis, bile leak and biloma, biliary strictures, and biliary casts. Ischemic cholangiopathies related to liver transplantation including nonanastomotic ischemic-type biliary stricture and biliary cast syndrome and also those associated with transarterial chemoembolization including bile duct necrosis and biloma are well known, though ischemic cholangiopathies also occur spontaneously and in other medical treatments. Hypoxic injuries to hepatic arterial branches including PVP and biliary epithelial cells (BECs) seem to be essential. In addition, ABH blood type and HLA antigens expressing on endothelial cells in the PVP and BECs in the large bile ducts could be targets by an immunological attack followed by the development of ischemic cholangiopathy. Further studies on the unique anatomy of the bile ducts supplied by PVP, both expressing graft-specific antigens, are essential for evaluation of and therapeutical approach to ischemic cholangiopathies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AS:

Anastomotic biliary stricture

BCS:

Biliary cast syndrome

BDN:

Bile duct necrosis

BECs:

Biliary epithelial cells

DSA:

Donor-specific antibodies

HR:

Hypoxia/reperfusion

IA:

Isoagglutinin

ITBL:

Ischemic-type biliary stricture

LPS:

Lipopolysaccharides

LT:

Liver transplantation

NAS:

Nonanastomotic biliary strictures

PAMPs:

Pathogen-associated molecular patterns

PCP:

Peribiliary capillary plexus

PRR:

Pathogen recognition receptors

PVP:

Peribiliary vascular plexus

ROS:

Reactive oxygen species

TACE:

Transarterial chemoembolization

TLRs:

Toll-like receptors

References

  1. Demetris AJ, Bellamy CO, Gandhi CR, Prost S, Nakanuma Y, Stolz DB. Functional immune anatomy of the liver – as an allograft. Am J Transplant. 2016;16(6):1653–80.

    Article  CAS  PubMed  Google Scholar 

  2. Nakanuma Y, Hoso M, Sanzen T, Sasaki M. Microstructure and development of the normal and pathologic biliary tract in humans, including blood supply. Microsc Res Tech. 1997;38(6):552–70.

    Article  CAS  PubMed  Google Scholar 

  3. Kobayashi S, Nakanuma Y, Matsui O. Intrahepatic peribiliary vascular plexus in various hepatobiliary diseases: a histological survey. Hum Pathol. 1994;25(9):940–6.

    Article  CAS  PubMed  Google Scholar 

  4. Kienlein S, Schoening W, Andert A, Kroy D, Neumann UP, Schmeding M. Biliary complications in liver transplantation: Impact of anastomotic technique and ischemic time on short- and long-term outcome. World J Transplant. 2015;5(4):300–9.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kobayashi S, Nakanuma Y, Terada T, Matsui O. Postmortem survey of bile duct necrosis and biloma in hepatocellular carcinoma after transcatheter arterial chemoembolization therapy: relevance to microvascular damages of peribiliary capillary plexus. Am J Gastroenterol. 1993;88(9):1410–5.

    CAS  PubMed  Google Scholar 

  6. Sun Z, Li G, Ai X, et al. Hepatic and biliary damage after transarterial chemoembolization for malignant hepatic tumors: incidence, diagnosis, treatment, outcome and mechanism. Crit Rev Oncol Hematol. 2011;79(2):164–74.

    Article  PubMed  Google Scholar 

  7. Hansen T, Hollemann D, Pitton MB, et al. Histological examination and evaluation of donor bile ducts received during orthotopic liver transplantation--a morphological clue to ischemic-type biliary lesion? Virchows Arch. 2012;461(1):41–8.

    Article  PubMed  Google Scholar 

  8. op den Dries S, Westerkamp AC, Karimian N, et al. Injury to peribiliary glands and vascular plexus before liver transplantation predicts formation of non-anastomotic biliary strictures. J Hepatol. 2014;60(6):1172–9117.

    Article  Google Scholar 

  9. Kono N, Nakanuma Y. Ultrastructural and immunohistochemical studies of the intrahepatic peribiliary capillary plexus in normal livers and extrahepatic biliary obstruction in human beings. Hepatology. 1992;15(3):411–8.

    Article  CAS  PubMed  Google Scholar 

  10. Lazaridis KN, LaRusso NF. The cholangiopathies. Mayo Clin Proc. 2015;90(6):791–800.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Celli A, Que FG, Gores GJ, et al. Glutathione depletion is associated with decreased Bcl-2 expression and increased apoptosis in cholangiocytes. Am J Phys. 1998;275(4Pt1):G749–57.

    CAS  Google Scholar 

  12. Dechêne A, Kodde C, Kathemann S, et al. Endoscopic treatment of pediatric post-transplant biliary complications is safe and effective. Dig Endosc. 2015;27(4):505–11.

    Article  PubMed  Google Scholar 

  13. Feng L, Pang L, Guo Y, et al. Hypoxia/reoxygenation up-regulates death receptor expression and enhances apoptosis in human biliary epithelial cells. Life Sci. 2009;85(9–10):401–7.

    Article  CAS  PubMed  Google Scholar 

  14. Beuers U, Hohenester S, de Buy Wenniger LJ, Kremer AE, Jansen PL, Elferink RP. The biliary HCO(3)(-) umbrella: a unifying hypothesis on pathogenetic and therapeutic aspects of fibrosing cholangiopathies. Hepatology. 2010;52(4):1489–96.

    Article  CAS  PubMed  Google Scholar 

  15. Nakanuma Y, Sasaki M, Harada K. Autophagy and senescence in fibrosing cholangiopathies. J Hepatol. 2015;62(4):934–45.

    Article  CAS  PubMed  Google Scholar 

  16. Land WG. Innate immunity-mediated allograft rejection and strategies to prevent it. Transplant Proc. 2007;39(3):667–72.

    Article  CAS  PubMed  Google Scholar 

  17. Jin S, Shi XJ, Sun XD, Wang SY, Wang GY. Sclerosing cholangitis secondary to bleomycin-iodinated embolization for liver hemangioma. World J Gastroenterol. 2014;20(46):17680–5.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Zhu XD, Shen ZY, Chen XG, Zang Y. Pathotyping and clinical manifestations of biliary cast syndrome in patients after an orthotopic liver transplant. Exp Clin Transplant. 2013;11(2):142–9.

    Article  PubMed  Google Scholar 

  19. Song GW, Lee SG, Hwang S, et al. Biliary stricture is the only concern in ABO-incompatible adult living donor liver transplantation in the rituximab era. J Hepatol. 2014;61(3):575–82.

    Article  CAS  PubMed  Google Scholar 

  20. Kaneku H, O’Leary JG, Banuelos N, et al. De novo donor-specific HLA antibodies decrease patient and graft survival in liver transplant recipients. Am J Transplant. 2013;13(6):1541–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Iacob S, Cicinnati VR, Dechêne A, et al. Genetic, immunological and clinical risk factors for biliary strictures following liver transplantation. Liver Int. 2012;32(8):1253–61.

    Article  CAS  PubMed  Google Scholar 

  22. Cardinale V, Wang Y, Carpino G, et al. The biliary tree – a reservoir of multipotent stem cells. Nat Rev Gastroenterol Hepatol. 2012;9(4):231–40.

    Article  CAS  PubMed  Google Scholar 

  23. Kulaksiz H, Heuberger D, Engler S, Stielhl A. Poor outcome in progressive sclerosing cholangitis after septic shock. Endoscopy. 2008;40(3):214–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Disclosures

None

Author information

Authors and Affiliations

  1. Department of Diagnostic Pathology, Shizuoka Cancer Center, Sunto-Nagaizumi 1007, Shizuoka, 411-8777, Japan

    Yasuni Nakanuma MD & Naoko Miyata MD

Authors
  1. Yasuni Nakanuma MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Naoko Miyata MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yasuni Nakanuma MD .

Editor information

Editors and Affiliations

  1. Department of Pathology, Shizuoka Cancer Center, Shizuoka, Japan

    Yasuni Nakanuma

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer Nature Singapore Pte Ltd.

About this chapter

Cite this chapter

Nakanuma, Y., Miyata, N. (2017). Vascular Supply of the Bile Duct and Ischemic Cholangiopathy. In: Nakanuma, Y. (eds) Pathology of the Bile Duct. Springer, Singapore. https://doi.org/10.1007/978-981-10-3500-5_5

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-3500-5_5

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-3499-2

  • Online ISBN: 978-981-10-3500-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation