Described as early as the 1950s(1),cholangioscopy has evolved from a burdensome intra-operative maneuver performed during open surgery,to a minimally-invasive,widely-available tool that can be utilized on demand durin...Described as early as the 1950s(1),cholangioscopy has evolved from a burdensome intra-operative maneuver performed during open surgery,to a minimally-invasive,widely-available tool that can be utilized on demand during endoscopic retrograde cholangiopancreatography(ERCP).The advent of the latest generation digital cholangioscopes with improved image quality,maneuverability,and the ability to pass tools through a dedicated instrument channel has revolutionized the modern approach to a wide variety of biliary disorders(2).展开更多
Primary sclerosing cholangitis (PSC) is a chronic and progressive cholestatic liver disease that often leads to the development of cirrhosis.Complications of PSC include pruritus,fatigue,vitamin deficiencies,metabolic...Primary sclerosing cholangitis (PSC) is a chronic and progressive cholestatic liver disease that often leads to the development of cirrhosis.Complications of PSC include pruritus,fatigue,vitamin deficiencies,metabolic bone disease,dominant biliary strictures,gallstones,and hepatobiliary malignancies,most commonly cholangiocarcinoma (CCA).Despite the presumed autoimmune etiology of PSC,a clear benefit from immunosuppressive agents has not yet been established,and their use is limited by their side effects.Endoscopy is required in evaluation of biliary strictures in PSC to rule out the possibility of CCA.Liver transplantation is currently the only life-extending therapy for patients with end-stage disease.However,disease recurrence can be a source of morbidity and mortality as transplanted patients survive longer.Further studies are needed to develop an optimal therapeutic strategy for patients with PSC to decrease the incidence of complications of the disease,to decrease the need for transplantation,and to extend life expectancy.展开更多
文摘Described as early as the 1950s(1),cholangioscopy has evolved from a burdensome intra-operative maneuver performed during open surgery,to a minimally-invasive,widely-available tool that can be utilized on demand during endoscopic retrograde cholangiopancreatography(ERCP).The advent of the latest generation digital cholangioscopes with improved image quality,maneuverability,and the ability to pass tools through a dedicated instrument channel has revolutionized the modern approach to a wide variety of biliary disorders(2).
文摘Primary sclerosing cholangitis (PSC) is a chronic and progressive cholestatic liver disease that often leads to the development of cirrhosis.Complications of PSC include pruritus,fatigue,vitamin deficiencies,metabolic bone disease,dominant biliary strictures,gallstones,and hepatobiliary malignancies,most commonly cholangiocarcinoma (CCA).Despite the presumed autoimmune etiology of PSC,a clear benefit from immunosuppressive agents has not yet been established,and their use is limited by their side effects.Endoscopy is required in evaluation of biliary strictures in PSC to rule out the possibility of CCA.Liver transplantation is currently the only life-extending therapy for patients with end-stage disease.However,disease recurrence can be a source of morbidity and mortality as transplanted patients survive longer.Further studies are needed to develop an optimal therapeutic strategy for patients with PSC to decrease the incidence of complications of the disease,to decrease the need for transplantation,and to extend life expectancy.
