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Management of extrahepatic cholestasis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The management of extrahepatic cholestasis depends on the cause.

There are three general risks when operating on a patient with extra-hepatic cholestasis:

  • hypocoagulability:
    • due to prothrombin deficiency
    • may be corrected by vitamin K administration

  • postoperative renal failure:
    • due to nephrotoxic effects of bile pigments and bowel toxins which escape hepatic detoxification
    • may be prevented with intra- and post-operative use of diuretics e.g. frusemide

  • sepsis:
    • the combination of biliary sepsis and renal failure is usually fatal
    • is prevented with prophylactic antibiotics

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