Endoscopic retrograde cholangiopancreatography in diagnosis and treatment of primary sclerosing cholangitis

• Verfasst von: Gotthardt, Daniel [VerfasserIn]
• Verfasst von: Stiehl, Adolf [VerfasserIn]
• Titel: Endoscopic retrograde cholangiopancreatography in diagnosis and treatment of primary sclerosing cholangitis
• Verf.angabe: Daniel Gotthardt, MD, Adolf Stiehl, MD
• E-Jahr: 2010
• Jahr: May 2010
• Umfang: 10 S.
• Fussnoten: Gesehen am 27.04.2023
• Titel Quelle: Enthalten in: Clinics in liver disease
• Ort Quelle: Oxford u.a. : Elsevier, 2002
• Jahr Quelle: 2010
• Band/Heft Quelle: 14(2010), 2, Seite 349-358
• ISSN Quelle: 1557-8224
• DOI: doi:10.1016/j.cld.2010.03.010
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Bile Ducts
• Sach-SW: Catheterization
• Sach-SW: Cholangiopancreatography, Endoscopic Retrograde
• Sach-SW: Cholangiopancreatography, Magnetic Resonance
• Sach-SW: Cholangitis, Sclerosing
• Sach-SW: Constriction, Pathologic
• Sach-SW: Early Detection of Cancer
• Sach-SW: Humans
• Sach-SW: Stents
• K10plus-PPN: 1843742721

Abstract

Primary sclerosing cholangitis is characterized by progressive fibrosing obliteration of the biliary tract. In some cases the disease is restricted to the small bile ducts, but most patients develop fibrotic stenoses of the larger bile ducts. Despite advances in magnetic resonance cholangiography, in unclear cases endoscopic retrograde cholangiography is necessary to make the correct diagnosis. In patients with total or subtotal strictures of the large bile ducts, these so-called dominant stenoses may be treated by endoscopic balloon dilatation and/or stent placement, though in the large majority of cases a stent placement is not necessary. Several studies showed an improvement of biochemical parameters after endoscopic treatment, and actuarial survival in these patients was improved compared with predicted survival. Endoscopic retrograde cholangiography allows tissue sampling, brush cytology, and bile analysis for early detection of cholangiocarcinoma, a major complication of primary sclerosing cholangitis. Despite successful endoscopic opening of bile duct stenoses, patients often progress to liver failure, leading to liver transplantation as the treatment of choice.