Cholangioscopy in primary sclerosing cholangitis: a case series of benign features.
| Autor: | Tejaswi S; Division of Gastroenterology & Hepatology, University of California Davis School of Medicine, Sacramento, California., Loehfelm TW; Department of Radiology, University of California Davis School of Medicine, Sacramento, California., Olson KA; Department of Pathology and Laboratory Medicine, University of California Davis School of Medicine, Sacramento, California. |
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| Jazyk: | angličtina |
| Zdroj: | VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy [VideoGIE] 2021 Jun 30; Vol. 6 (9), pp. 431-437. Date of Electronic Publication: 2021 Jun 30 (Print Publication: 2021). |
| DOI: | 10.1016/j.vgie.2021.05.008 |
| Abstrakt: | Background and Aims: Cholangioscopy is useful in establishing a visual diagnosis of cholangiocarcinoma (CCA), but this is harder to achieve in primary sclerosing cholangitis (PSC) because of the stricture-forming nature of the disease. Furthermore, it can be harder to differentiate malignant from benign features of the underlying inflammation. This case series demonstrates the varied features of nonmalignant inflammatory findings in PSC. Methods: A single experienced endoscopist performed cholangioscopy for PSC cases referred for ERCP. Results: Cholangioscopy in these 5 cases without CCA demonstrated the features of acute and chronic inflammation, acute inflammatory mass, dominant stricture, acute cholangitis in a duct with features of chronic inflammation with a large pigmented stone, and fibrostenotic disease. Cholangioscopic maneuvers such as advancement across strictures after balloon dilation, targeted mucosal biopsy, and electrohydraulic lithotripsy (EHL) of impacted stones are demonstrated. The relevant radiographic and histopathologic features of the disease accompany each case description. Regarding long-term prognosis, 1 case of acute inflammatory mass and a case of worsening liver function required a liver transplant evaluation, whereas the other 3 cases remain stable. Conclusions: Cholangioscopic features of benign disease in PSC are varied. Knowledge of these features is essential in differentiating between benign and malignant findings. These features, combined with biopsy and cytology evaluation, can help in tailoring management in patients with benign PSC. (© 2021 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc.) |
| Databáze: | MEDLINE |
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