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Features of biliary tract diseases in ketamine abusers: a systematic review of case reports.

Alireza Teymouri, Hadis Nasoori, Maryamsadat Fakheri, Aref Nasiri

Journal of Medical Case Reports March 3, 2024 DOI: 10.1186/s13256-024-04421-6 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Systematic review Case report Peer reviewed
Sample size 17
Population Adult patients with documented ketamine abuse and cholangiopathy or biliary tract disease
Topics Addiction Ketamine Esketamine
Keywords Biliary tract disease Substance abuse Ketamine abuse Biliary disease Drug-induced cholangiopathy Young adult health
Citations 20
Key findings Ketamine-induced cholangiopathy typically presents in young men with abdominal pain, abnormal liver function, and bile duct dilation, and most patients improve with supportive care.

Abstract

Anesthesiologists prefer ketamine for certain surgeries due to its effectiveness as a non-competitive inhibitor of the N-methyl-D-aspartate receptor in the brain. Recently, this agent has also shown promise as an antidepressant. However, ketamine can cause hallucinogenic effects and is sometimes abused as an illicit drug. Ketamine abuse has been associated with liver and bile duct complications. This systematic study aims to better understand cholangiopathy in ketamine abusers by reviewing case reports. In this systematic review, a comprehensive literature search was conducted with the terms "biliary tract diseases" and "ketamine". Case reports and case series of adult patients with documented ketamine abuse and reported cholangiopathy or biliary tract disease were included. We extracted the data of relevant information and the results were reported through narrative synthesis and descriptive statistics. A total of 48 studies were initially identified, and 11 studies were finally included in the review. The mean age of the patients was 25.88 years. Of the 17 patients, 64.7% were men. Symptoms often included abdominal pain, nausea, and vomiting. Most patients were discharged with improved symptoms and liver function. Common bile duct dilation and other findings were observed in imaging results and other diagnostic studies. This review highlights the diverse presentations and diagnostic modalities used in ketamine-induced cholangiography. These patients tend to be young men with deranged liver function tests and abdominal pain, which should be taken into consideration. These patients often require a multidisciplinary approach in their management.

Comparable studies

Other systematic reviews and meta-analyses on ketamine for addiction, most cited first.

Study Year Design Participants
Ketamine use: a review Ketamine users 2011 Systematic review
Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review 2021 Systematic review
Therapeutic Potentials of Ketamine and Esketamine in Obsessive–Compulsive Disorder (OCD), Substance Use Disorders (SUD) and Eating Disorders (ED): A Review of the Current Literature 2021 Systematic review
Efficacy of ketamine intervention to decrease alcohol use, cravings, and withdrawal symptoms in adults with problematic alcohol use or alcohol use disorder: A systematic review and comprehensive analysis of mechanism of actions. People with harmful alcohol use, alcohol craving, or alcohol withdrawal states,... 2022 Systematic review n = 634
Ketamine Treatment for Alcohol Use Disorder: A Systematic Review. Adult patients with alcohol use disorder, heavy drinkers, or those undergoing alcohol... 2023 Systematic review n = 854

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