Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline

被引：153

作者：

Aabakken, Lars ^{[1
,2
]}

Karlsen, Tomh. ^{[3
,4
,5
]}

Albert, Joerg ^{[6
]}

Arvanitakis, Marianna ^{[7
]}

Chazouilleres, Olivier ^{[8
]}

Dumonceau, Jean-Marc ^{[9
]}

Farkkila, Martti ^{[10
]}

Fickert, Peter ^{[11
]}

Hirschfield, Gideon M. ^{[12
,13
]}

Laghi, Andrea ^{[14
]}

Marzioni, Marco ^{[15
]}

Fernandez, Michael

Pereira, Stephen P. ^{[16
]}

Pohl, Juergen ^{[17
]}

Poley, Jan-Werner ^{[18
]}

Ponsioen, Cyriel Y. ^{[19
]}

Schramm, Christoph ^{[20
,21
]}

Swahn, Fredrik ^{[22
,23
]}

Tringali, Andrea ^{[24
]}

Hassan, Cesare ^{[25
]}

机构：

[1] Univ Oslo, GI Endoscopy, Univ Hosp, Rikshosp, Oslo, Norway

[2] Univ Oslo, Fac Med, Oslo, Norway

[3] Univ Oslo, Norwegian PSC Res Ctr, Oslo, Norway

[4] Univ Oslo, Div Canc Med Surg & Transplantat, Dept Transplantat Med, Sect Gastroenterol,Oslo Univ Hosp,Rikshosp, Oslo, Norway

[5] Univ Oslo, Inst Clin Med, Oslo, Norway

[6] Robert Bosch Krankenhaus, Abt Gastroenterol Hepatol & Endokrinol, Stuttgart, Germany

[7] Univ Libre Bruxelles, Dept Gastroenterol Hepatopancreatol & Digest Onco, Erasme Hosp, Brussels, Belgium

[8] UPMC Univ Paris 06, Ctr Reference Malad Inflammatoires Foie & Voies B, Hop St Antoine, Assistance Publ Hop Paris,Ser Hepatol, Paris, France

[9] Gedyt Endoscopy Ctr, Buenos Aires, DF, Argentina

[10] Univ Helsinki, Cent Hosp, Dept Gastroenterol, Helsinki, Finland

[11] Med Univ Graz, Res Unit Expt & Mol Hepatol, Div Gastroenterol & Hepatol, Dept Internal Med, Graz, Austria

[12] Univ Birmingham, NIHR, Birmingham Liver Biomed Res Unit BRU, Birmingham, W Midlands, England

[13] Univ Birmingham, Liver Res Ctr, Birmingham, W Midlands, England

[14] Sapienza Univ, Pathol Sci, Rome, Italy

[15] Univ Politecn Marche, Osped Riuniti, Univ Hosp, Clin Gastroenterol & Hepatol, Ancona, Italy

[16] UCL, Inst Liver & Digest Hlth, Royal Free Campus, London, England

[17] Klinikum Friedrichshain, Dept Gastroenterol & Intervent Endoscopy, Berlin, Germany

[18] Erasmus MC, Univ Med Ctr, Dept Gastroenterol & Hepatol, Rotterdam, Netherlands

[19] Acad Med Ctr, Dept Gastroenterol & Hepatol, Amsterdam, Netherlands

[20] Univ Med Ctr Hamburg Eppendorf, Dept Med 1, Hamburg, Germany

[21] Univ Med Ctr Hamburg Eppendorf, Martin Zeitz Ctr Rare Dis, Hamburg, Germany

[22] Karolinska Inst, Ctr Digest Dis, Karolinska Univ Hosp, Stockholm, Sweden

[23] Karolinska Inst, Div Surg, CLINTEC, Stockholm, Sweden

[24] Catholic Univ, Digest Endoscopy Unit, Rome, Italy

[25] Nuovo Regina Margherita Hosp, Digest Endoscopy Unit, Rome, Italy

来源：

ENDOSCOPY | 2017年 / 49卷 / 06期

关键词：

INFLAMMATORY-BOWEL-DISEASE; BILIARY BRUSH CYTOLOGY; MAGNETIC-RESONANCE CHOLANGIOGRAPHY; POST-ERCP PANCREATITIS; BILE-DUCT STRICTURES; LOW-GRADE DYSPLASIA; RETROGRADE CHOLANGIOPANCREATOGRAPHY; ULCERATIVE-COLITIS; DOMINANT STRICTURES; RISK-FACTORS;

D O I：

10.1055/s-0043-107029

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

MAIN RECOMMENDATIONS 1 ESGE/EASL recommend that, as the primary diagnostic modality for PSC, magnetic resonance cholangiography (MRC) should be preferred over endoscopic retrograde cholangiopancreatography (ERCP). Moderate quality evidence, strong recommendation. 2 ESGE/EASL suggest that ERCP can be considered if MRC plus liver biopsy is equivocal or contraindicated in patients with persisting clinical suspicion of PSC. The risks of ERCP have to be weighed against the potential benefit with regard to surveillance and treatment recommendations. Low quality evidence, weak recommendation. 6 ESGE/EASL suggest that, in patients with an established diagnosis of PSC, MRC should be considered before therapeutic ERCP. Weak recommendation, low quality evidence. 7 ESGE/EASL suggest performing endoscopic treatment with concomitant ductal sampling (brush cytology, endobiliary biopsies) of suspected significant strictures identified at MRC in PSC patients who present with symptoms likely to improve following endoscopic treatment. Strong recommendation, low quality evidence. 9 ESGE/EASL recommend weighing the anticipated benefits of biliary papillotomy/sphincterotomy against its risks on a case-by-case basis. Strong recommendation, moderate quality evidence. Biliary papillotomy/sphincterotomy should be considered especially after difficult cannulation. Strong recommendation, low quality evidence. 16 ESGE/EASL suggest routine administration of prophylactic antibiotics before ERCP in patients with PSC. Strong recommendation, low quality evidence. 17 EASL/ESGE recommend that cholangiocarcinoma (CCA) should be suspected in any patient with worsening cholestasis, weight loss, raised serum CA19-9, and/or new or progressive dominant stricture, particularly with an associated enhancing mass lesion. Strong recommendation, moderate quality evidence. 19 ESGE/EASL recommend ductal sampling (brush cytology, endobiliary biopsies) as part of the initial investigation for the diagnosis and staging of suspected CCA in patients with PSC. Strong recommendation, high quality evidence. © Georg Thieme Verlag KG Stuttgart - New York.

引用

页码：588 / 608

页数：21

共 126 条

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Sclerosing cholangitis: A focus on secondary causes [J].