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...
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MDPI AG
2020-04-01
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| Series: | Diagnostics |
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| author | Toshio Fujisawa Mako Ushio Sho Takahashi Wataru Yamagata Yusuke Takasaki Akinori Suzuki Yoshihiro Okawa Kazushige Ochiai Ko Tomishima Shigeto Ishii Hiroaki Saito Hiroyuki Isayama |
| author_facet | Toshio Fujisawa Mako Ushio Sho Takahashi Wataru Yamagata Yusuke Takasaki Akinori Suzuki Yoshihiro Okawa Kazushige Ochiai Ko Tomishima Shigeto Ishii Hiroaki Saito Hiroyuki Isayama |
| author_sort | Toshio Fujisawa |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-10T20:08:52Z |
| format | Article |
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| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T20:08:52Z |
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| series | Diagnostics |
| spelling | doaj.art-dd8f140046e34fd196e093d71fac24872023-11-19T23:04:23ZengMDPI AGDiagnostics2075-44182020-04-0110526810.3390/diagnostics10050268Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing CholangitisToshio Fujisawa0Mako Ushio1Sho Takahashi2Wataru Yamagata3Yusuke Takasaki4Akinori Suzuki5Yoshihiro Okawa6Kazushige Ochiai7Ko Tomishima8Shigeto Ishii9Hiroaki Saito10Hiroyuki Isayama11Department of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanDepartment of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanDepartment of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanDepartment of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanDepartment of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanDepartment of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanDepartment of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanDepartment of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanDepartment of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanDepartment of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanDepartment of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanDepartment of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, JapanPrimary 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.https://www.mdpi.com/2075-4418/10/5/268primary sclerosing cholangitischolangioscopyIgG4-related sclerosing cholangitischolangiocarcinomascarringpseudodiverticula |
| spellingShingle | Toshio Fujisawa Mako Ushio Sho Takahashi Wataru Yamagata Yusuke Takasaki Akinori Suzuki Yoshihiro Okawa Kazushige Ochiai Ko Tomishima Shigeto Ishii Hiroaki Saito Hiroyuki Isayama Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis Diagnostics primary sclerosing cholangitis cholangioscopy IgG4-related sclerosing cholangitis cholangiocarcinoma scarring pseudodiverticula |
| 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 | primary sclerosing cholangitis cholangioscopy IgG4-related sclerosing cholangitis cholangiocarcinoma scarring pseudodiverticula |
| url | https://www.mdpi.com/2075-4418/10/5/268 |
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