CHOLANGIOSCOPIC EXAMINATION AND THERAPY FOR PRIMARY SCLEROSING CHOLANGITIS: REPORT OF A CASE

Abstract

A 63-year old man visited our hospital for detailed examination of liver dysfunction discovered in a routine medical check-up. Abdominal US and EUS showed irregular thichening of the common bile duct, while ERCP showed stenosis and irregular rosary-like lesions in the lower bile duct. The diagnosis of primary selerosing cholangitis was made on the basis of these findings. PTCS was conducted to determine the presence or absence of cholangiocarcinoma. The biliary mucosa was rough and showed redness, scars and diverticulum-like changes. No evidence of malignant findings was noted in any examinations, including histological examination of a biopsy specimens taken by cholangioscope. The stenosed portion of the bile duct was coagulated and dilated using micro-wave under PTCS and the drainage tube was withdrawn when hepatic function tests returned to normal after creating a percutaneous drainage route. Treatment using cholangioscopy seems to have been effective, since hepatic function has remained normal for 30 months sincc the corrcction of stcnosis.