Zusammenfassung
Die Primär Sklerosierende Cholangitis (PSC) ist durch eine zunehmende fibrosierende Entzündung charakterisiert, die zu Strikturen der intra- und extrahepatischen Gallenwege führt. Die PSC ist eine langsam fortschreitende Erkrankung mit einem wechselhaften Verlauf, der häufig zur biliären Leberzirrhose führt. Die Obstruktion der Gallenwege kann sowohl zur Cholestase und bakteriellen Cholangitis führen, als auch zur raschen Verschlechterung der Leberfunktion. Des Weiteren wurde festgestellt, dass etwa 8–19% der PSC-Patienten während ihres Krankheitsverlaufs ein Cholangiokarzinom entwickeln (Broome et al. 1996; Wiesner et al. 1996). Viele PSC-Patienten bleiben symptomlos, während andere an Beschwerden leiden, die als Müdigkeit, Juckreiz, Ikterus, rechtsseitiger Oberbauchschmerz oder als bakterielle Cholangitis in Erscheinung treten. Eine Erhöhung der Leberwerte im Blut kann auftreten.
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Literatur
Beuers U, Spengler U, Kruis W et al. (1992) Ursodeoxycholic acid for treatment of primary sclerosing cholangitis: a placebo controled trial. Hepatology 16: 707–714
Broome U, Olsson R, Loof L et al. (1996) Natural history and prognostic factors in 305 Swedish patients with primary sclerosing cholangitis. Gut 38: 610–615
Cotton PB, Nicki N (1991) Endoscopic and radiologic approaches to therapy in primary sclerosing cholangitis. Semin Liver Dis 11: 40–48
Franklin KJ, Fulcher AS, Turner MA, Allison MC, Sterling RK, Christian J, Allison K, Shiffman ML (1999) Magnetic resonance cholangiography (MRC) vs. endoscopic retrograde cholangiography (ERC) for diagnosis of primary sclerosing cholangitis (PSC). A blinded case control study ( Abstract ). Gastroenterology A 837
Gaing A A, Geders JM, Cohen SA, Siegel JH (1993) Endosopic managment of primary sclerosing cholangitis: review, and report of an open series. Am J Gastroenterol 88: 2000–2008
Grijm R, Huibregtse K, Bartelsman J, Mathus-Vliegen EM, Dekker W, Tytgat GN (1986) Thera-peutic investigations in primary sclerosing cholangitis. Dig Dis Sci 31 [8]: 792–798
Ismail T, Angrisani L, Powell JE, Hubscher S, Buckels J, Neuberger J, Elias E, McMaster P (1991) Primary sclerosing cholangitis: surgical options, prognostic variables and outcome. Br J Surg 78: 564–567
Johnson GK, Geenen JE, Venu RP, Schmalz MJ, Hogan WJ (1991) Endoscopic treatment of biliary strictures in sclerosing cholangitis: a larger series and recommendations for treatment. Gastrointest Endosc 37: 38–43
Knollmann FD, Adler A, Mäurer J, Grünewald T, Hintze RE, Schedel H, Veltzke W (1995) Comparative imaging of HIV associated diseases of the hepatobiliary system in computerized tomography and cholangiography. Aktuelle Radiol 5: 216–221
LaRusso NF, Wiesner RH, Ludwig J, MacCarty RL (1984) Current concepts: Primary sclerosing cholangitis. N Engl J Med 310 [14]: 899–903
Lee JG, Schutz SM, England RE, Leung JW, Cotton PB (1995) Endoscopic therapy of sclerosing cholangitis. Hepatology 21 [3]: 661–667
May GR, Bender CE, LaRusso NF, Wiesner RH (1985) Nonoperative dilatation of dominant strictures in primary sclerosing cholangitis. Am J Roentgenol 145: 1061–1064
Mueller PR, van Sonnenberg E, Ferrucci JT Jr, Weymann PJ, Butch RJ, Malt RA, Burhenne HJ (1986) Biliary stricture dilatation: multicenter review of clinical management in 73 patients. Radiology 160: 17–22
Oberholzer K, Lohse AW, Mildenberger P, Grebe P, Schadeck T, Bantelmann M, Thelen M (1998) Diagnosis of primary sclerosing cholangitis: prospective comparison of MR cholangiography with endoscopic retrograde cholangiography. Rofo (Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr) 169 [6]: 622–666
Ponsioen CY, Lam K, van Miliigen de Wit AW, Huibregtse K, Tytgat GN (1999) Four years ex¬perience with short term stenting in primary sclerosing cholangitis. Am J Gastroenterol 94 [9]: 2403–2407
Sanchez-Urdazpal L, Gores GJ, Ward EM, Maus TP, Buckel EG, Steers JL, Wiesner RH, Krom RA (1993) Diagnostic features and clinical outcome of ischemic-type biliary complications after liver transplantation. Hepatology 17 [4]: 605–609
Skolkin MD, Alspaugh JP, Casarella WG, Chuang VP, Galambos JT (1989) Sclerosing cholangitis: palliation with percutaneous cholangioplasty. Radiology 170: 199–206
Stiehl A, Rudolph G, Sauer P, Benz C, Stremmel W, Walker S, Theilmann L (1997) Efficacy of ursodeoxycholic acid treatment and endoscopic dilation of major duct stenoses in primary sclerosing cholangitis. An 8-year prospective study. J Hepatol 26 [3]: 560–566
Stiehl A, Walker S, Stiehl L, Rudolph G, Hofmann WJ, Theilmann L (1994) Effect of ursodeoxycholic acid on liver and bile duct disease in primary sclerosing cholangitis. A 3-year pilot study with a placebo-controlled study period. J Hepatol 20 [1]: 57–64
Van Miliigen de Wit AW, van Bracht J, Rauws EA, Jones EA, Tytgat GN, Huibregtse K (1996) Endoscopic stent therapy for dominant extrahepatic bile duct strictures in primary sclerosing cholangitis. Gastrointest. Endosc 44 [3]: 293–299
Verbeek PC, van Leeuwen DJ, de Wit LT, Reeders JW, Smits NJ, Bosma A, Huibregtse K, van der Heyde MN (1992) Benign fibrosing disease at the hepatic confluence mimicking Klatskin tumors. Surgery 112 [5]: 866–871
Wagner S, Gebel M, Meier P, Trautwein C, Bleck J, Nashan B, Manns MP (1996) Endoscopic managment of biliary strictures in primary sclerosing cholangitis. Endoscopy 28: 546–551
Wiesner RH, Porayko MK, Hay JE, LaRusso NF, Steers JL, Krom RA, Dickson ER (1996) Liver transplantation for primary sclerosing cholangitis: impact of risk factors on outcome. Liver Transpl. Surg 25 [Suppl 1]: 99–108
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Hintze, R.E., Abou-Rebyeh, H., Veltzke-Schlieker, W., Adler, A., Wiedenmann, B. (2001). Endoskopische Therapiemöglichkeiten der PSC. In: Dignass, A., Stein, J. (eds) Chronisch entzündliche Darmerkrankungen. Gastroenterologie Update, vol 2000. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59556-1_18
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DOI: https://doi.org/10.1007/978-3-642-59556-1_18
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