PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 3063908

[Primary sclerosing cholangitis].

T Rösch·H Dancygier
View original source ↗Export metadata ↓

Abstract

Primary sclerosing cholangitis (PSC) is a chronic fibrous-obliterative inflammation of bile ducts of unknown origin. Genetic, infectious and immunological mechanisms are believed to be involved in the pathogenesis. The clinical signs and symptoms in the early stages are non-specific, laboratory evaluation shows a marked elevation of alkaline phosphatase and a lower rise of transaminases. The diagnosis is confirmed by endoscopic retrograde cholangiography. Histologic findings are non-specific. About 60% of patients with PSC have chronic inflammatory bowel disease, mainly ulcerative colitis. The risk of developing carcinoma of the bile ducts is also increased in patients with PSC. Therapy with glucocorticoids, colchicin, immunosuppressive agents, cholestyramin and penicillamin generally is unsatisfactory. In advanced stages liver transplantation should be performed.

Explore related subjects

Bile DuctsCholangitis, SclerosingHumansLiverEnglish AbstractJournal ArticleReview

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

T Rösch, H Dancygier. 1988. [Primary sclerosing cholangitis].. https://pubmed.ncbi.nlm.nih.gov/3063908/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2006

Management strategy for congenital choledochal cyst with co-existing intrahepatic dilation and aberrant bile duct as well as other complicated biliary anomalies.

The purpose of this study was to investigate and discuss imaging methods and management strategies for congenital choledochal cyst with co-existing intrahepatic dilation and aberrant bile duct as well as other complicated biliary anomalies. In this study we reviewed and analyzed 72 patients with congenital choledochal cyst, ranging in age from 15 days to 12 years old and who were seen at our hospital during the past 12 years, from January 1993 to October 2005. The image manifestation and clinical significance of patients with co- existing intrahepatic biliary dilation and aberrant bile duct were carefully examined during operation via MRCP, cholangiography and choledochoscope. Twenty-two cases (30.1%) presented with intrahepatic bile duct dilation and 12 of these were of the cystic type. That is, the orifice of the dilated intrahepatic tract that converged into the common hepatic duct showed membrane or septum-like stenosis. In 10 cases the dilation tapered off from the porta hepatis to the initiating terminals of the intra-hepatic bile ducts and was not accompanied by stenosis. An aberrant bile duct was observed in 2 of the cases. In 3 cases, the right and left hepatic ducts converged at the choledochal cyst. In conclusion, the imaging methods for intrahepatic bile duct dilation possess important clinical significance. Further, for hepatojejunostomy with radical excision of a choledochal cyst, additional operative procedures for intrahepatic stenosis, possible bile duct malformation and pancreaticobiliary common duct calculi can potentially reduce postoperative complications.

Bile Ducts↗
PubMed2006

Vascular injuries in laparoscopic cholecystectomy: an underestimated problem.

BACKGROUND: Bile duct injury is a severe complication of laparoscopic cholecystectomy and many reports focus on this topic, especially regarding the long-term success of repair of these injuries. There is some concern, however, as to whether concomitant vascular injuries can jeopardize reconstruction of a bile duct injury following laparoscopic cholecystectomy. METHODS: A review of the current literature on the clinical significance and management of a concomitant vascular injury to the outcome of reconstruction of bile duct injuries following laparoscopic cholecystectomy. Relevant articles were extracted through PubMed, with secondary references obtained from key articles. RESULTS: Although the relevant literature is generally poor, there is a trend of appearance of relatively large series on the topic over the last five years, as opposed to case reports or small series during the previous decade. CONCLUSION: The disruption of the hepatic arterial flow during laparoscopic cholecystectomy is usually well tolerated in an otherwise healthy patient. There is strong evidence that concomitant vascular injuries do not have any impact on mortality after biliary reconstruction. There is also evidence that does increase overall morbidity, but when it comes specifically to long-term anastomotic stricture formation, there is no strong evidence to support a negative impact of a concomitant vascular injury; this is especially true for centers/surgeons with HPB interest.

Bile Ducts↗