| Theme |
PSC and PBC -- Recent Progress in Diagnosis and Treatment |
| Title |
Endoscopic Treatment with Biliary Stents for PSC |
| Author |
Suguru Mizuno |
Department of Gastroenterology, Toshiba General Hospital / Department of Gastroenterology, Faculty of Medicine, University of Tokyo |
| Author |
Hiroyuki Isayama |
Department of Gastroenterology, Faculty of Medicine, University of Tokyo |
| Author |
Takeo Watanabe |
Department of Gastroenterology, Faculty of Medicine, University of Tokyo |
| Author |
Kenji Hirano |
Department of Gastroenterology, Faculty of Medicine, University of Tokyo |
| Author |
Minoru Tada |
Department of Gastroenterology, Faculty of Medicine, University of Tokyo |
| Author |
Kazuhiko Koike |
Department of Gastroenterology, Faculty of Medicine, University of Tokyo |
| [ Summary ] |
Primary sclerosing cholangitis (PSC) is characterized by multiple biliary strictures and usually leads to biliary cirrhosis. Liver transplantation is the only treatment to cure this disease. The purpose of endoscopic treatment with biliary stents is to delay a clinical course toward liver failure. Careful selection of the indications for endoscopic stent placement in PSC patients is important, because this treatment often complicates conditions related to cholangitis in the undrained area of the liver. A better indication for endoscopic treatment is the more distal strictures with dilatation of the proximal biliary tract. Trial drainage with naso-biliary catheters before stent placement is useful to select likely cases for endoscopic drainage. Endoscopists should note hemorrhagic tendencies and gastro-esophageal varices due to liver cirrhosis when considering this procedure. They should not be reluctant to perform percutaneous drainage when cholangitis becomes uncontrollable after endoscopic stent placement. |