Secondary sclerosing cholangitis: A comparison to primary sclerosing cholangitis
Secondary sclerosing cholangitis: A comparison to primary sclerosing cholangitis
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DOI：
10.1111/j.1572-0241.2005.41526.x
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发表时间：
2005-06-01
影响因子：
9.8
通讯作者：
Lindor, KD
中科院分区：
文献类型：
--
作者：
Gossard, AA;Angulo, P;Lindor, KD
继发性硬化性胆管炎（SSC）的自然病程不明确。为了更好地确定这种情况的自然史，我们回顾性分析了明尼苏达州罗切斯特的马约诊所的数据。我们还比较了诊断为原发性硬化性胆管炎（PSC）的诊断与SSC患者的自然史的一个队列：我们使用了计算机辅助搜索，以确定诊断为SSC的患者看到从1992年至2002年。通过病历回顾和有关年龄、性别、病因、治疗和临床病程的信息确认诊断。我们排除了那些有炎症性肠病病史的假定SSC患者，诊断时患有恶性肿瘤的患者，以及在诊断SSC之前接受过肝移植的患者。与年龄、性别和血清胆红素水平相匹配的PSC患者作为疾病对照。结果：我们确定了31例患者，平均年龄57岁（范围28-79岁）。SSC的原因包括胆囊切除术（13例患者），导管内结石（12例患者），复发性胰腺炎（4例患者）和腹部损伤（2例患者）。9例SSC患者最终需要肝移植，4例患者死亡。当与匹配的PSC患者相比时，无移植存活率显著缩短（p < 0.03）。结论：当将SSC患者的长期结果与匹配的PSC对照相比时，SSC患者的结果较差。SSC的自然史的特征是预期寿命缩短。
OBJECTIVES: The natural history of secondary sclerosing cholangitis (SSC) is ill-defined. In order to better determine the natural history of this condition, we retrospectively reviewed data from the Mayo Clinic in Rochester, Minnesota. We also compared the natural history of patients diagnosed with SSC to a cohort with a diagnosis of primary sclerosing cholangitis (PSC).METHODS: We used a computer-assisted search to identify patients with a diagnosis of SSC seen from 1992 to 2002. The diagnosis was confirmed by chart review and information about age, gender, etiology, therapy, and clinical course was sought. We excluded those presumed SSC patients who had a history of inflammatory bowel disease, those with malignancy at the time of diagnosis, and those who had undergone liver transplantation prior to the diagnosis of SSC. Patients with PSC matched for age, gender, and serum bilirubin level served as disease controls.RESULTS: We identified 31 patients, average age 57, (range 28-79). The causes of SSC included surgical trauma from cholecystectomy (13 patients), intraductal stones (12 patients), recurrent pancreatitis (4 patients), and abdominal injury (2 patients). Nine patients with SSC ultimately required liver transplantation and 4 patients have died. When compared to matched patients with PSC, the survival free of transplant was significantly shortened (p < 0.03).CONCLUSIONS: When the long-term outcome of SSC patients was compared to matched PSC controls, the SSC patients had a poorer outcome. The natural history of SSC is characterized by a shortened life expectancy.