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Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis
Primary sclerosing cholangitis (PSC) is characterized by idiopathic biliary stricture followed by progressive cholestasis and fibrosis. When diagnosing PSC, its differentiation from other types of sclerosing cholangitis and cholangiocarcinoma is necessary. The cholangioscopic findings of PSC have no...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277921/ https://www.ncbi.nlm.nih.gov/pubmed/32365686 http://dx.doi.org/10.3390/diagnostics10050268 |
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author | Fujisawa, Toshio Ushio, Mako Takahashi, Sho Yamagata, Wataru Takasaki, Yusuke Suzuki, Akinori Okawa, Yoshihiro Ochiai, Kazushige Tomishima, Ko Ishii, Shigeto Saito, Hiroaki Isayama, Hiroyuki |
author_facet | Fujisawa, Toshio Ushio, Mako Takahashi, Sho Yamagata, Wataru Takasaki, Yusuke Suzuki, Akinori Okawa, Yoshihiro Ochiai, Kazushige Tomishima, Ko Ishii, Shigeto Saito, Hiroaki Isayama, Hiroyuki |
author_sort | Fujisawa, Toshio |
collection | PubMed |
description | Primary sclerosing cholangitis (PSC) is characterized by idiopathic biliary stricture followed by progressive cholestasis and fibrosis. When diagnosing PSC, its differentiation from other types of sclerosing cholangitis and cholangiocarcinoma is necessary. The cholangioscopic findings of PSC have not been investigated sufficiently. PSC and IgG4-related sclerosing cholangitis are difficult to distinguish by peroral cholangioscopy (POCS), but POCS is useful for excluding cholangiocarcinoma. POCS findings vary according to the condition and stage of disease. In the active phase, findings such as mucosal erythema, ulceration, fibrinous white exudate, and an irregular surface are observed and may reflect strong inflammation in the biliary epithelium. On the other hand, findings such as scarring, pseudodiverticula, and bile duct stenosis appear in the chronic phase and may reflect fibrosis and stenosis resulting from repeated inflammation. Observation of inside the bile duct by POCS might confirm the current PSC activity. Because POCS offers not only information regarding the diagnosis of PSC and PSC-associated cholangiocarcinoma but also the current statuses of biliary inflammation and stenosis, POCS could significantly contribute to the diagnosis and treatment of PSC once the characteristic findings of PSC are confirmed by future studies. |
format | Online Article Text |
id | pubmed-7277921 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-72779212020-06-12 Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis Fujisawa, Toshio Ushio, Mako Takahashi, Sho Yamagata, Wataru Takasaki, Yusuke Suzuki, Akinori Okawa, Yoshihiro Ochiai, Kazushige Tomishima, Ko Ishii, Shigeto Saito, Hiroaki Isayama, Hiroyuki Diagnostics (Basel) Review Primary sclerosing cholangitis (PSC) is characterized by idiopathic biliary stricture followed by progressive cholestasis and fibrosis. When diagnosing PSC, its differentiation from other types of sclerosing cholangitis and cholangiocarcinoma is necessary. The cholangioscopic findings of PSC have not been investigated sufficiently. PSC and IgG4-related sclerosing cholangitis are difficult to distinguish by peroral cholangioscopy (POCS), but POCS is useful for excluding cholangiocarcinoma. POCS findings vary according to the condition and stage of disease. In the active phase, findings such as mucosal erythema, ulceration, fibrinous white exudate, and an irregular surface are observed and may reflect strong inflammation in the biliary epithelium. On the other hand, findings such as scarring, pseudodiverticula, and bile duct stenosis appear in the chronic phase and may reflect fibrosis and stenosis resulting from repeated inflammation. Observation of inside the bile duct by POCS might confirm the current PSC activity. Because POCS offers not only information regarding the diagnosis of PSC and PSC-associated cholangiocarcinoma but also the current statuses of biliary inflammation and stenosis, POCS could significantly contribute to the diagnosis and treatment of PSC once the characteristic findings of PSC are confirmed by future studies. MDPI 2020-04-29 /pmc/articles/PMC7277921/ /pubmed/32365686 http://dx.doi.org/10.3390/diagnostics10050268 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Fujisawa, Toshio Ushio, Mako Takahashi, Sho Yamagata, Wataru Takasaki, Yusuke Suzuki, Akinori Okawa, Yoshihiro Ochiai, Kazushige Tomishima, Ko Ishii, Shigeto Saito, Hiroaki Isayama, Hiroyuki Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis |
title | Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis |
title_full | Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis |
title_fullStr | Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis |
title_full_unstemmed | Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis |
title_short | Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis |
title_sort | role of peroral cholangioscopy in the diagnosis of primary sclerosing cholangitis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277921/ https://www.ncbi.nlm.nih.gov/pubmed/32365686 http://dx.doi.org/10.3390/diagnostics10050268 |
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