Dominant strictures in patients with primary sclerosing cholangitis
Dominant strictures in patients with primary sclerosing cholangitis
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DOI：
10.1111/j.1572-0241.2004.04106.x
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发表时间：
2004-03-01
影响因子：
9.8
通讯作者：
Olsson, R
中科院分区：
文献类型：
--
作者：
Björnsson, E;Lindqvist-Ottosson, J;Olsson, R
背景：据报道，优势狭窄（DS）的重复内镜扩张对原发性硬化性胆管炎（PSC）患者有益。我们的目的是确定PSC患者中DS的患病率以及ALP和胆红素的自发过程，从诊断为DS的患者和非DS的患者开始长达一年。方法：对125例PSC患者的胆管造影进行再评价。DS定义为胆总管（CBD）直径小于或等于1.5 mm和/或右肝管（RHD）或左肝管（LHD）直径小于或等于1.0 mm。结果：125例患者中有56例（45%）主要出现胆总管和/或右肝管或左肝管狭窄。合并和未合并DS患者胆管造影前碱性磷酸酶平均值分别为16和15.2 mumol/L，胆红素平均值分别为42和35 mumol/L （NS）。在有和没有DS的患者中，从胆管造影前2个月和12个月观察到的ALP和胆红素的变化没有显著差异。结论：PSC患者的胆汁淤积似乎与DS的存在无关。内镜治疗退行性椎体滑移不应常规进行，需要随机研究来阐明其潜在的益处。
Background: Repeat endoscopic dilatations of dominant strictures (DS) have been reported to be of benefit in patients with primary sclerosing cholangitis (PSC). We aimed to determine the prevalence of DS in patients with PSC and the spontaneous course of ALP and bilirubin, up to a year from diagnosis in patients with and without DS.Method: Cholangiographies from 125 patients with PSC were reevaluated. DS was defined as a stenosis less than or equal to1.5 mm in diameter of the common bile duct (CBD) and/or less than or equal to1.0 mm of right (RHD) or left hepatic duct (LHD).Results: A dominant stricture in common bile duct and/or right hepatic duct or left hepatic duct was present in 56 out of 125 (45%) patients. Mean values for alkaline phosphatase were 16 and 15.2 mukat/L and bilirubin values were 42 and 35 mumol/L before cholangiography in patients with and without DS, respectively (NS). The change in ALP and bilirubin observed from the precholangiographic value up to 2 and 12 months afterward was not significantly different in those with and without DS.Conclusions: Cholestasis in patients with PSC does not seem to be related to the presence of DS. Endoscopic therapy of DS should not be routinely undertaken and randomized studies are needed to clarify its potential benefits.