Cangemi J R, Wiesner R H, Beaver S J, Ludwig J, MacCarty R L, Dozois R R, Zinsmeister A R, LaRusso N F
Department of Diagnostic Radiology.
Gastroenterology. 1989 Mar;96(3):790-4.
The effect of proctocolectomy on the primary sclerosing cholangitis that frequently is associated with chronic ulcerative colitis in patients with both conditions is unknown. We have studied prospectively the progression of clinical, biochemical, cholangiographic, and hepatic histologic features in 45 patients with both primary sclerosing cholangitis and chronic ulcerative colitis to compare these variables in the 20 patients who had undergone proctocolectomy with the 25 who had not. The two groups were similar initially with regard to clinical, biochemical, cholangiographic, and hepatic histologic findings. All patients were followed for a minimum of 1 yr and overall duration of follow-up was similar in both groups (4.1 vs. 3.9 yr). Clinically, new onset of hepatomegaly, splenomegaly, esophageal varices, and ascites did not differ in patients with and without proctocolectomy. Biochemically, the serial changes in bilirubin, alkaline phosphatase, aspartate aminotransferase, prothrombin time, and albumin were similar. Histologic progression on liver biopsy did not differ between groups, nor did changes on serial cholangiograms. Proctocolectomy also had no effect on survival. We conclude that proctocolectomy for chronic ulcerative colitis has no beneficial effect on the primary sclerosing cholangitis in patients with both diseases.
在患有原发性硬化性胆管炎和慢性溃疡性结肠炎这两种疾病的患者中，直肠结肠切除术对常与慢性溃疡性结肠炎相关的原发性硬化性胆管炎的影响尚不清楚。我们前瞻性地研究了45例原发性硬化性胆管炎和慢性溃疡性结肠炎患者的临床、生化、胆管造影和肝脏组织学特征的进展情况，以比较20例接受直肠结肠切除术的患者和25例未接受该手术的患者的这些变量。两组患者在最初的临床、生化、胆管造影和肝脏组织学检查结果方面相似。所有患者至少随访1年，两组的总随访时间相似（4.1年对3.9年）。临床上，有或没有接受直肠结肠切除术的患者出现肝肿大、脾肿大、食管静脉曲张和腹水的新发情况并无差异。生化方面，胆红素、碱性磷酸酶、天冬氨酸转氨酶、凝血酶原时间和白蛋白的系列变化相似。两组患者肝脏活检的组织学进展以及系列胆管造影的变化均无差异。直肠结肠切除术对生存率也没有影响。我们得出结论，针对慢性溃疡性结肠炎进行的直肠结肠切除术对患有这两种疾病的患者的原发性硬化性胆管炎没有有益影响。
