Laparoscopic findings in primary sclerosing cholangitis

Citation
F. Ikeda et al., Laparoscopic findings in primary sclerosing cholangitis, ENDOSCOPY, 33(3), 2001, pp. 267-270
Citations number
18
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery,"Medical Research Diagnosis & Treatment
Journal title
ENDOSCOPY
ISSN journal
0013-726X → ACNP
Volume
33
Issue
3
Year of publication
2001
Pages
267 - 270
Database
ISI
SICI code
0013-726X(200103)33:3<267:LFIPSC>2.0.ZU;2-Z
Abstract
Background and Study Aims: Primary sclerosing cholangitis (PSC) is a choles tatic disease characterized by segmental narrowing and dilatation of bile d ucts, Few studies have been performed on the laparoscopic findings associat ed with this disease, and the present study was intended to assess the usef ulness of laparoscopy for the diagnosis and staging of PSC, Patients and Methods: Six patients were examined by laparoscopy with liver biopsy. Repeated laparoscopy was performed in three patients, Results: Laparoscopy revealed coarse surface irregularity and discoloration . Surface irregularity was classified into four grades: smooth, shallowly d epressed, undulated, and nodular. The affected area showed whitish yellow d iscoloration. The discolored area was demonstrated as a poorly stained area by intravenous injection of indocyanine green (ICG), Lobular markings beca me apparent because of the yellow color change in the portal tract, resulti ng in a leopardskin-like appearance. Lymph-vessel dilatation was seen in ad vanced stages. Repeated laparoscopy of a patient without treatment demonstr ated a progression from a smooth surface to a shallow depression with leopa rdskin-like markings. On the other hand, the two patients treated with immu nosuppressive agents showed improvement of liver swelling and disappearance of the leopardskin-like markings and lymph-vessel dilatation. Conclusions: Laparoscopy may provide useful information for the diagnosis a nd staging of PSC.