Webster, G.J.M.; Whittmann, J.; Hatfield, A.R.; Pereira, S.P.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA24
Academic Journal
Background: in patients with PSC, the optimal management of the m nority who develop dominant biliary strictures remains uncertain. Several studies suggest a survival benefit of endoscopic dilatation +/stent insertion compared with expectant management alone, but they have generally reported only short term follow up. Aim: To review the endoscopic management of PSC in a tertiary referral centre, and to assess the impact of intervention on outcome. Methods: Cases were identified via endoscopy, pathology and clinical databases, from 1984-2000. The numbers of ERCPs, interventions, length of endoscopic follow up, and outcome, were compared in patients with and without dominant strictures. Results: Of 161 patients identified with PSC, 131 (85M, 46F; mean age 55 years, range 14-86 years) underwent 382 ERCPs during the study period (3.4% of 11 326 ERCPs). Interventions and endoscopic follow up in the patients are shown in the table. Of stricture interventions performed, stent insertion alone was performed in > 65% of cases, dilatation alone in < 25% of cases. Discussion: This single centre experience indicates that patients with dominant strictures due to PSC can be successfully managed long term with endoscopic therapy. Ongoing prospective follow-up will allow the effects of biliary interventions on clinical outcome to be assessed in detail.


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