Etiology of Ischemic Cholangiopathy Common causes of ischemic cholangiopathy include Vascular injury during orthotopic liver transplantation or laparoscopic cholecystectomy Graft-rejection injury Chemoembolization Radiation therapy Thrombosis resulting from hypercoagulability disorders Bile duct injury (ischemic necrosis) results, causing cholestasis, cholangitis, or biliary strictures (often multiple).