Thosani Nirav, Banerjee Subhas
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 300 Pasteur Drive, MC: 5244, Stanford, CA 94305, USA.
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 300 Pasteur Drive, MC: 5244, Stanford, CA 94305, USA.
Clin Liver Dis. 2014 Nov;18(4):899-911. doi: 10.1016/j.cld.2014.07.013. Epub 2014 Sep 6.
Although there are no randomized, controlled trials evaluating the efficacy of endoscopic retrograde cholangiography (ERC) in primary sclerosing cholangitis (PSC) patients, substantial indirect evidence supports the effectiveness of ERC in symptomatic PSC patients with a dominant stricture. Currently, cumulative evidence supports the role of ERC with endoscopic dilation with or without additional short-term stent placement for symptomatic PSC patients with a dominant stricture. Differentiating benign dominant strictures from cholangiocarcinoma (CCA) remains difficult; however, newer endoscopic techniques and advanced cytologic techniques are likely to improve sensitivity for the diagnosis of CCA over that achieved by traditional cytology brushing alone.
尽管尚无随机对照试验评估内镜逆行胆管造影术（ERC）对原发性硬化性胆管炎（PSC）患者的疗效，但大量间接证据支持ERC对有明显狭窄的症状性PSC患者有效。目前，累积证据支持对有明显狭窄的症状性PSC患者，采用ERC联合内镜扩张术（无论是否额外短期置入支架）。区分良性明显狭窄与胆管癌（CCA）仍然困难；然而，更新的内镜技术和先进的细胞学技术可能会提高CCA的诊断敏感性，超过单纯传统细胞学刷检所达到的水平。
