期刊文献+

Diagnosis and management of primary sclerosing cholangitis-perspectives from a therapeutic endoscopist 被引量:2

Diagnosis and management of primary sclerosing cholangitis-perspectives from a therapeutic endoscopist
下载PDF
导出
摘要 Primary sclerosing cholangitis(PSC) is a chronic,cholestatic liver condition characterized by inflammation,fibrosis,and destruction of the intra-and extrahepatic bile ducts.The therapeutic endoscopist plays a key role in the diagnosis and management of PSC.In patients presenting with a cholestatic profile,endoscopic retrograde cholangiopancreatography(ERCP) is warranted for a definite diagnosis of PSC.Dominant strictures of the bile duct occur in 36%-57% of PSC patients.Endoscopic balloon dilatation with or without stenting have been employed in the management of dominant strictures.In addition,PSC patients are at increased risk of developing cholangiocarcinoma with a 20% lifetime risk.Brush cytology obtained during ERCP and use of fluorescence in situ hybridization forms the initial diagnostic step in the investigation of patients with dominant biliary strictures.Our review aims to summarize the current evidence supporting the role of a therapeutic endoscopist in the management of PSC patients. Primary sclerosing cholangitis (PSC) is a chronic, cholestaticliver condition characterized by inflammation,fibrosis, and destruction of the intra- and extrahepaticbile ducts. The therapeutic endoscopist plays a key rolein the diagnosis and management of PSC. In patientspresenting with a cholestatic profile, endoscopic retrogradecholangiopancreatography (ERCP) is warrantedfor a definite diagnosis of PSC. Dominant strictures of thebile duct occur in 36%-57% of PSC patients. Endoscopicballoon dilatation with or without stenting have beenemployed in the management of dominant strictures. Inaddition, PSC patients are at increased risk of developingcholangiocarcinoma with a 20% lifetime risk. Brushcytology obtained during ERCP and use of fluorescencein situ hybridization forms the initial diagnostic step in theinvestigation of patients with dominant biliary strictures.Our review aims to summarize the current evidencesupporting the role of a therapeutic endoscopist in themanagement of PSC patients.
出处 《World Journal of Hepatology》 CAS 2015年第5期799-805,共7页 世界肝病学杂志(英文版)(电子版)
基金 Research Grants from the Inflammatory Bowel Disease Working Group and the American College of Gastroenterology(to Navaneethan U)
  • 引文网络
  • 相关文献

参考文献60

  • 1Navaneethan U, Shen B. Hepatopancreatobiliary manifestationsand complications associated with inflammatory bowel disease.Inflamm Bowel Dis 2010; 16: 1598-1619 [PMID: 20198712 DOI:10.1002/ibd.21219].
  • 2Gohlke F, Lohse AW, Dienes HP, L-hr H, M-rker-HermannE, Gerken G, Meyer zum Büschenfelde KH. Evidence for anoverlap syndrome of autoimmune hepatitis and primary sclerosingcholangitis. J Hepatol 1996; 24: 699-705 [PMID: 8835745 DOI:10.1016/S0168-8278(96)80266-2].
  • 3Bambha K, Kim WR, Talwalkar J, Torgerson H, Benson JT, TherneauTM, Loftus EV, Yawn BP, Dickson ER, Melton LJ. Incidence, clinicalspectrum, and outcomes of primary sclerosing cholangitis in a UnitedStates community. Gastroenterology 2003; 125: 1364-1369 [PMID:14598252 DOI: 10.1016/j.gastro.2003.07.011].
  • 4MacCarty RL, LaRusso NF, Wiesner RH, Ludwig J. Primary sclerosingcholangitis: findings on cholangiography and pancreatography.Radiology 1983; 149: 39-44 [PMID: 6412283 DOI: 10.1148/radiology.149.1.6412283].
  • 5Lee YM, Kaplan MM. Primary sclerosing cholangitis. N EnglJ Med 1995; 332: 924-933 [PMID: 7877651 DOI: 10.1056/NEJM199504063321406].
  • 6Angulo P, Larson DR, Therneau TM, LaRusso NF, Batts KP,Lindor KD. Time course of histological progression in primarysclerosing cholangitis. Am J Gastroenterol 1999; 94: 3310-3313[PMID: 10566735 DOI: 10.1111/j.1572-0241.1999.01543.x].
  • 7Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM,Shneider B, Gores GJ. Diagnosis and management of primarysclerosing cholangitis. Hepatology 2010; 51: 660-678 [PMID:20101749 DOI: 10.1002/hep.23294].
  • 8Burak KW, Angulo P, Lindor KD. Is there a role for liver biopsyin primary sclerosing cholangitis- Am J Gastroenterol 2003; 98:1155-1158 [PMID: 12809842 DOI: 10.1111/j.1572-0241.2003.07401.x].
  • 9Angulo P, Pearce DH, Johnson CD, Henry JJ, LaRusso NF,Petersen BT, Lindor KD. Magnetic resonance cholangiographyin patients with biliary disease: its role in primary sclerosingcholangitis. J Hepatol 2000; 33: 520-527 [PMID: 11059855 DOI:10.1034/j.1600-0641.2000.033004520.x].
  • 10Dave M, Elmunzer BJ, Dwamena BA, Higgins PD. Primary sclerosing cholangitis: meta-analysis of diagnostic performanceof MR cholangiopancreatography. Radiology 2010; 256: 387-396[PMID: 20656832 DOI: 10.1148/radiol.10091953].

同被引文献7

引证文献2

二级引证文献9

;
使用帮助 返回顶部