原发性硬化性胆管炎诊断和治疗专家共识(2015)

中华医学会肝病学分会，中华医学会消化病学分会，中华医学会感染病学分会

doi:10.3969/j.issn.1001-5256.2016.01.003

原发性硬化性胆管炎诊断和治疗专家共识(2015)

DOI: 10.3969/j.issn.1001-5256.2016.01.003

中华医学会肝病学分会，中华医学会消化病学分会，中华医学会感染病学分会

详细信息

中图分类号: R575.7
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出版历程
- 出版日期: 2016-01-20

Consensus on the diagnosis and management of primary sclerosing cholangitis(2015)

Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association

摘要

摘要:
<正>1概述原发性硬化性胆管炎(primary sclerosing cholangitis,PSC)是一种以特发性肝内外胆管炎症和纤维化导致多灶性胆管狭窄为特征、慢性胆汁淤积病变为主要临床表现的自身免疫性肝病。上述胆道的改变用目前可查的任何继发因素都无法予以解释,故需与继发性硬化性胆管炎相鉴别。PSC发病隐匿,患者早期常无典型病情进行性加重可导致反复胆道梗阻和胆管炎症,最终可发展为肝硬化和肝衰竭,故早期的诊断及处理对
- 胆管炎,硬化性 /
- 诊断 /
- 治疗 /
- 共识
- cholangitis,sclerosing /
- diagnosis /
- therapy /
- consensus

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参考文献(56)

[1]LINDKVIST B,BENITO de VALLE M,GULLBERG B,et al.Incidence and prevalence of primary sclerosing cholangitis in a defined adult population in Sweden[J].Hepatology,2010,52(2):571-577.

[2]BAMBHA K,KIM WR,TALWALKAR J,et al.Incidence,clinical spectrum,and outcomes of primary sclerosing cholangitis in a United Statescommunity[J].Gastroenterology,2003,125(5):1364-1369.

[3]KAPLAN GG,LAUPLAND KB,BUTZNER D,et al.The burden of large and small duct primary sclerosing cholangitis in adults and children:a population-based analysis[J].Am J Gastroenterol,2007,102(5):1042-1049.

[4]BOONSTRA K,BEUERS U,PONSIOEN CY.Epidemiology of primary sclerosing cholangitis and primary biliary cirrhosis:a systematic review[J].J Hepatol,2012,56(5):1181-1188.

[5]MOLODECKY NA,KAREEMI H,PARAB R,et al.Incidence of primary sclerosing cholangitis:a systematic review and meta-analysis[J].Hepatology,2011,53(5):1590-1599.

[6]KOCHHAR R,GOENKA MK,DAS K,et al.Primary sclerosing cholangitis:an experience from India[J].J Gastroenterol Hepatol,1996,11(5):429-433.

[7]KINGHAM JG,KOCHAR N,GRAVENOR MB.Incidence,clinical patterns,and outcomes of primary sclerosing cholangitis in South Wales,United Kingdom[J].Gastroenterology,2004,126(7):1929-1930.

[8]ANG TL,FOCK KM,NG TM,et al.Clinical profile of primary sclerosing cholangitis in Singapore[J].J Gastroenterol Hepatol,2002,17(8):908-913.

[9]TAKIKAWA H,TAKAMORI Y,TANAKA A,et al.Analysis of388 cases of primary sclerosing cholangitis in Janpan;Presence of a subgroup without pancreatic involvement in older patients[J].Hepatol Res,2004,29(3):153-159.

[10]BENITO de VALLE M,RAHMAN M,LINDKVIST B,et al.Factors that reduce health-related quality of life in patients with primary sclerosing cholangitis[J].Clin Gastroenterol Hepatol,2012,10(7):769-775.

[11]TISCHENDORF JJ,HECKER H,KRGER M,et al.Characterization,outcome,and prognosis in 273 patients with primary sclerosing cholangitis:a single center study[J].Am J Gastroenterol,2007,102(1):107-114.

[12]STANICH PP,BJRNSSON E,GOSSARD AA,et al.Alkaline phosphatase normalization is associated with better prognosis in primary sclerosing cholangitis[J].Dig Liver Dis,2011,43(4):309-313.

[13] MENDES FD,JORGENSEN R,KEACH J,et al.Elevated serum IgG 4 concentration in patients with primary sclerosing cholangitis[J].Am J Gastroenterol,2006,101(9):2070-2075.

[14]SCHULTE-PELKUM J,RADICE A,NORMAN GL,et al.Novel clinical and diagnostic aspects of antineutrophil cytoplasmic antibodies[J].J Immunol Res,2014,2014:185416.

[15]PLEVY S.Do serological markers and cytokines determine the indeterminate?[J].J Clin Gastroenterol,2004,38(5 Suppl 1):s51-s56.

[16]FREEMAN ML,NELSON DB,SHERMAN S,et al.Complications of endoscopic biliary sphincterotomy[J].N Engl J Med,1996,335(13):909-918.

[17]BANGARULINGAM SY,GOSSARD AA,PETERSEN BT,et al.Complications of endoscopic retrograde cholangiopancreatography inprimary sclerosing cholangitis[J].Am J Gastroenterol,2009,104(4):855-860.

[18]MOFF SL,KAMEL IR,EUSTACE J,et al.Diagnosis of primary sclerosing cholangitis:a blinded comparative study using magnetic resonance cholangiography and endoscopic retrograde cholangiography[J].Gastrointest Endosc,2006,64(2):219-223.

[19]DAVE M,ELMUNZER BJ,DWAMENA BA,et al.Primary sclerosing cholangitis:meta-analysis of diagnostic performance of MR cholangiopancreatography[J].Radiology,2010,2569(2):387-396.

[20]BERSTAD AE,AABAKKEN L,SMITH HJ,et al.Diagnostic accuracy of magnetic resonance and endoscopic retrograde cholangiography in primary sclerosing cholangitis[J].Clin Gastroenterol Hepatol,2006,4(4):514-520.

[21]PORTMANN B,ZEN Y.Inflammatory disease of the bile ductscholangiopathies:liver biopsy challenge and clinicopathological correlation[J].Histopathology,2012,60(2):236-248.

[22]TABIBIAN JH,LINDOR KD.Ursodeoxycholic acid in primary sclerosing cholangitis:if withdrawal is bad,then administration is good(right?)[J].Hepatology,2014,60(3):785-788.

[23]OLSSON R,BOBERG KM,de MUCKADELL OS,et al.Highdose ursodeoxycholic acid in primary sclerosing cholangitis:a 5-year multicenter,randomized,controlled study[J].Gastroenterology,2005,129(5):1464-1472.

[24]WUNSCH E,TROTTIER J,MILKIEWICZ M,et al.Prospective evaluation of ursodeoxycholic acid withdrawal in patients with primary sclerosing cholangitis[J].Hepatology,2014,60(3):931-940.

[25]KAYA M,PETERSEN BT,ANGULO P,et al.Balloon dilation compared to stenting of dominant strictures in primary sclerosing cholangitis[J].Am J Gastroenterol,2001,96(4):1059-1066.

[26]ALJIFFRY M,RENFREW PD,WALSH MJ,et al.Analytical review of diagnosis and treatment strategies for dominant bile duct strictures in patients with primary sclerosing cholangitis[J].HPB(Oxford),2011,13(2):79-90.

[27]CHAPMAN MH,WEBSTER GJ,BANNOO S,et al.Cholangiocarcinoma and dominant strictures in patients with primary sclerosing cholangitis:a 25-year single-centre experience[J].Eur J Gastroenterol Hepatol,2012,24(9):1051-1058.

[28]BALUYUT AR,SHERMAN S,LEHMAN GA,et al.Impact of endoscopic therapy on the survival of patients with primary sclerosing cholangitis[J].Gastrointest Endosc,2001,53(3):308-312.

[29]STIEHL A,RUDOLPH G,KLTERS-PLACHKY P,et al.Development of dominant bile duct stenoses in patients with primary sclerosing cholangitis treated with ursodeoxycholic acid:outcome after endoscopic treatment[J].J Hepatol,2002,36(2):151-156.

[30]van MILLIGEN de WIT AW,van BRACHT J,RAUWS EA,et al.Endoscopic stent therapy for dominant extrahepatic bile duct strictures in primary sclerosing cholangitis[J].Gastrointest Endosc,1996,44(2):293-299.

[31]ANDRIULLI A,LOPERFIDO S,NAPOLITANO G,et al.Incidence rates of post-ERCP complications:a systematic survey of prospective studies[J].Am J Gastroenterol,2007,102(8):1781-1788.

[32]HEIF M,YEN RD,SHAN RJ.ERCP with probe-based confocal laser endomicroscopy for the evaluation of dominant biliary stenoses in primary sclerosing cholangitis patients[J].Dig Dis Sci,2013,58(7):2068-2074.

[33]KIM JH,BYUN JH,LEE SJ,et al.Differential diagnosis of sclerosing cholangitis with autoimmune pancreatitis and periductal infiltrating cancer in the common bile duct at dynamic CT,endoscopic retrograde cholangiography and MR cholangiography[J].Eur Radiol,2012,22(11):2502-2513.

[34]KATO T,KOMORI A,BAE SK,et al.Concurrent systemic AA amyloidosis can discriminate primary sclerosing cholangitis from IgG 4-associated cholangitis[J].World J Gastroenterol,2012,18(2):192-196.

[35]ENNS R,ELOUBEIDI MA,MERGENER K,et al.Predictors of successful clinical and laboratory outcomes in patients with primary sclerosing cholangitis undergoing endoscopic retrograde cholangiopancreatography[J].Can J Gastroenterol,2003,17(4):243-248.

[36]YIMAM KK,BOWLUS CL.Diagnosis and classification of primary sclerosing cholangitis[J].Autoimmun Rev,2014,13(4-5):445-450.

[37]PONSIOEN CY,VROUENRAETS SM,PRAWIRODIRDJO W,et al.Natural history of primary sclerosing cholangitis and prognostic value of cholangiography in a Dutch population[J].Gut,2002,51(4):562-566.

[38]CAMPSEN J,ZIMMERMAN MA,TROTTER JF,et al.Clinically recurrent primary sclerosing cholangitis following liver transplantation:a time course[J].Liver Transpl,2008,14(2):181-185.

[39]ANGULO P,MAOR-KENDLER Y,LINDOR KD.Small-duct primary sclerosing cholangitis:a long-term follow-up study[J].Hepatology,2002,35(6):1494-1500.

[40]BOONSTRA K,WEERSMA RK,van ERPECUM KJ,et al.Population-based epidemiology,malignancy risk,and outcome of primary sclerosing cholangitis[J].Hepatology,2013,58(6):2045-2055.

[41]KAYA M,ANGULO P,LINDOR KD.Overlap of autoimmune hepatitis and primary sclerosing cholangitis:an evaluation of a modified scoring system[J].J Hepatol,2000,33(4):537-542.

[42]van BUUREN HR,van HOOGSTRATEN HJE,TERKIVATAN T,et al.High prevalence of autoimmune hepatitis among patients with primary sclerosing cholangitis[J].J Hepatol,2000,33(4):543-548.

[43]AL-CHALABI T,PORTMANN BC,BERNAL W,et al.Autoimmune hepatitis overlap syndromes:an evaluation of treatment response,long-term outcome and survival[J].Aliment Pharmacol Ther,2008,28(2):209-220.

[44]BOBERG KM,FAUSA O,HAALAND T,et al.Features of autoimmune hepatitis in primary sclerosing cholangitis:an evaluation of114 primary sclerosing cholangitis patients according to a scoring system for the diagnosis of autoimmune hepatitis[J].Hepatology,1996,23(6):1369-1376.

[45]OHARA H,OKAZAKI K,TSUBOUCHI H,et al.Clinical diagnostic criteria of IgG 4-related sclerosing cholangitis 2012[J].J Hepatobiliary Pancreat Sci,2012,19(5):536-542.

[46]GHAZALE A,CHARI ST,ZHANG L,et al.Immunoglobulin G4-associated cholangitis:clinical profile and response to therapy[J].Gastroenterology,2008,134(3):706-715.

[47]WEBSTER GJ,PEREIRA SP,CHAPMAN RW,et al.Autoimmune pancreatitis/IgG 4-associated cholangitis and primary sclerosing cholangitis-overlapping or separate diseases?[J].J Hepatol,2009,51(2):398-402.

[48]BERNSTEIN CN,BLANCHARD JF,RAWSTHORNE P,et al.The prevalence of extraintestinal diseases in inflammatory bowel disease:a population-based study[J].Am J Gastroenterol,2001,96(4):1116-1122.

[49]CLAESSEN MM,VLEGGAAR FP,TYTGAT KM,et al.High lifetime risk of cancer in primary sclerosing cholangitis[J].J Hepatol,2009,50(1):158-164.

[50]HIRSCHFIELD GM,KARLSEN TH,LINDOR KD,et al.Primary sclerosing cholangitis[J].Lancet,2013,382(9904):1587-1599.

[51]NAKAZAWA T,NAITOH I,HAYASHI K,et al.Inflammatory bowel disease of primary sclerosing cholangitis:a distinct entity?[J].World J Gastroenterol,2014,20(12):3245-3254.

[52]BOONSTRA K,van ERPECUM KJ,van NIEUWKERK KM,et al.Primary sclerosing cholangitis is associated with a distinct phenotype of inflammatory bowel disease[J].Inflamm Bowel Dis,2012,18(12):2270-2276.

[53]KARLSEN TH,SCHRUMP E,BOBERG KM.Gallbladder polyps in primary sclerosing cholangitis:not so benign[J].Curr Opin Gastroenterol,2008,24(3):395-399.

[54]SOETIKNO RM,LIN OS,HEIDENREICH PA,et al.Increased risk of colorectal neoplasia in patients with primarys clerosing cholangitis and ulcerative colitis:a meta-analysis[J].Gastrointest Endosc,2002,56(1):48-54.

[55]BURAK K,ANGULO P,PASHA TM,et al.Incidence and risk factors for cholangiocarcinoma in primary sclerosing cholangitis[J].Am J Gastroenterol,2004,99(3):523-526.

[56]IMAM MH,THACKERAY EW,LINDOR KD.Colonic neoplasia in young patienls with inflammatory bowel disease and primary sclerosing cholangitis[J].Colorectal Dis,2013,15(2):198-203.

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