Summerfield J A, Elias E, Hungerford G D, Nikapota V L, Dick R, Sherlock S
Gastroenterology. 1976 Feb;70(2):240-3.
Endoscopic retrograde cholangiograms from 23 patients with primary biliary cirrhosis (PBC), 10 controls with either normal livers or hepatocellular disease, and 4 patients with sclerosing cholangitis, were compared. Of the PBC group, 39% had gallstones. The calibers of the common bile duct and left and right intrahepatic ducts were comparable in the PBC and control groups. The small intrahepatic ducts, while normal in the control group were abnormal in 7 of the 23 PBC patients. These small ducts were irregular in caliber and had a tortuous course. The changes were not related to the presence of gallstones or the duration of the disease, but all the patients had histologically proven cirrhosis. Two patients with cirrhosis had normal intrahepatic ducts. We conclude that whereas the major bile ducts are normal in PBC, there is a high incidence of gallstones (39%), and the changes that do occur in the intrahepatic ducts are probably related to the distorted hepatic architecture due to cirrhosis and may be used as a sign that cirrhosis has supervened.
对23例原发性胆汁性肝硬化（PBC）患者、10例肝脏正常或患有肝细胞疾病的对照者以及4例硬化性胆管炎患者的内镜逆行胆管造影进行了比较。在PBC组中，39%的患者有胆结石。PBC组和对照组的胆总管以及左右肝内胆管的管径相当。对照组肝内小胆管正常，而23例PBC患者中有7例异常。这些小胆管管径不规则，走行迂曲。这些改变与胆结石的存在或疾病持续时间无关，但所有患者均经组织学证实有肝硬化。两名肝硬化患者的肝内胆管正常。我们得出结论，虽然PBC患者的主要胆管正常，但胆结石发病率较高（39%），肝内胆管发生的改变可能与肝硬化导致的肝脏结构扭曲有关，并且可作为肝硬化已经出现的一个征象。
