Johnson G K, Geenen J E, Venu R P, Hogan W J
Gastrointest Endosc. 1987 Feb;33(1):9-12. doi: 10.1016/s0016-5107(87)71475-8.
Endoscopic sphincterotomy was performed on 10 patients with sclerosing cholangitis to improve biliary tract drainage and to remove bile duct sludge and stones. In addition, Gruentzig-type balloons were placed endoscopically to dilate severe biliary duct strictures in eight of these patients, and endoprostheses were inserted to bridge high grade strictures in three patients. In order to assess the effectiveness of endoscopic treatment, we compared the number of hospitalizations for clinical episodes of cholangitis in this patient group for similar periods of time before and after therapy. Episodes of cholangitis requiring hospitalization decreased from 2.5 +/- 0.4 per patient in the 12 months prior to endoscopic therapy to 0.2 +/- 0.2 episodes per patient in the year following treatment and to 0.33 +/- 0.2 episodes per patient in the additional follow-up period during the second year. Liver function tests have improved significantly over the follow-up period of 19.1 +/- 2.6 months from the time of endoscopic treatment. The serum bilirubin decreased from 6.9 +/- 2.0 mg/dl to 2.7 +/- 1.4 mg/dl; serum alkaline phosphatase decreased from 959 +/- 214 IU to 385 +/- 89 IU; and serum transaminase decreased from 117 +/- 17 IU to 77 +/- 12 IU. Endoscopic treatment appears to be effective in patients with severe sclerosing cholangitis.
对10例硬化性胆管炎患者实施了内镜括约肌切开术，以改善胆道引流并清除胆管内的胆泥和结石。此外，对其中8例患者在内镜下放置了Gruentzig型球囊以扩张严重的胆管狭窄，并对3例患者插入了内支架以跨越高度狭窄。为评估内镜治疗的效果，我们比较了该患者组在治疗前后相似时间段内因胆管炎临床发作而住院的次数。需要住院治疗的胆管炎发作次数从内镜治疗前12个月的每位患者2.5±0.4次降至治疗后一年的每位患者0.2±0.2次，在第二年的额外随访期降至每位患者0.33±0.2次。自内镜治疗后19.1±2.6个月的随访期内，肝功能检查有显著改善。血清胆红素从6.9±2.0mg/dl降至2.7±1.4mg/dl；血清碱性磷酸酶从959±214IU降至385±89IU；血清转氨酶从117±17IU降至77±12IU。内镜治疗对重度硬化性胆管炎患者似乎有效。
