Abstract:
:In 1992, a 61-year-old man who complained of recurrent episodes of fever and jaundice was diagnosed as having sclerosing cholangitis. In the three years that followed, the clinical picture progressively worsened; and, in 1995, the patient was hospitalized again for biliary obstruction. A liver transplantation was excluded because of concomitant severe coronary heart disease. A percutaneous transhepatic cholangiogram showed several critical strictures of the intrahepatic biliary tree and a temporary internal-external biliary drainage was placed to relieve the obstruction. After 40 days, a two-step percutaneous biliary balloon dilation was performed followed by topical steroid treatment through the catheter. After 45 days, the catheter was removed and steroid treatment tapered orally. In the three years that followed, the patient was well. He experienced only about 1-2 episodes of ascending cholangitis per year requiring antimicrobial therapy. Laboratory analysis showed a gradual improvement in hepatic chemistry, serum bilirubin, and erythrocyte sedimentation rate (ESR). In our patient, the association of percutaneous balloon dilation and topical steroid treatment improved both the clinical and radiological picture, without significant side-effects. This approach should be considered a valuable and cost-effective option in primary sclerosing cholangitis, mainly for patients not eligible for liver transplantation.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Tritto G,Iaccarino V,De Martino S,D'Agostino Ldoi
10.1097/00004836-200003000-00017subject
Has Abstractpub_date
2000-03-01 00:00:00pages
205-9issue
2eissn
0192-0790issn
1539-2031journal_volume
30pub_type
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journal_title:Journal of clinical gastroenterology
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pub_type: 杂志文章,评审
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pub_type: 临床试验,杂志文章
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