Surgery for segmental primary sclerosing cholangitis.

[Guest guest]

Hepatogastroenterology. 2004 May.

Surgery for segmental primary sclerosing cholangitis.Department of Surgery II, Osaka, Japan.Primary sclerosing cholangitis is an uncommon chronic hepatobiliary disorder, and the definitive surgical treatment for symptomatic primary sclerosing cholangitis is liver transplantation. Although some cases with primary sclerosing cholangitis treated with hepaticojejunostomy or partial hepatectomy have been reported, the indications for these procedures and their long-term results have not been well defined or studied. We present three patients with segmental primary sclerosing cholangitis, and discuss the indication of surgical treatment for primary sclerosing cholangitis excluding liver transplantation. Three patients with segmental primary sclerosing cholangitis of the common bile duct and the hepatic ducts were treated by hepaticojejunostomy with partial resection of the common bile duct. We investigated clinical features such as angiography, cholangiography, and surgical treatment outcomes. It was difficult to differentiate primary sclerosing cholangitis from a cholangioma preoperatively, despite the use of cytology, angiography, and cholangiography. Two of the three patients were preoperatively suspected to have cholangioma. Segmental primary sclerosing cholangitis was diagnosed operatively. All patients were treated hepaticojejunostomy and achieved long-term survival. Although liver transplantation is the treatment of choice for primary sclerosing cholangitis, in cases of segmental primary sclerosing cholangitis, local resection of the involved structures may be curative. Resection of a discrete lesion may provide many years of survival with a good quality of life, in some cases obviating the need for liver transplantation.

[Guest guest]

Surgery for segmental primary sclerosing cholangitis.Barb, You dear girl, how did you ever come up with this article ? This is definately me! and I love the words: local resection of the involved structures may be curative.

Thank you,

Mark and from Las Vegas!!!

PSC 2003, Resection 2003 (Cured?)

Surgery for segmental primary sclerosing cholangitis.

Hepatogastroenterology. 2004 May.

Surgery for segmental primary sclerosing cholangitis.Department of Surgery II, Osaka, Japan.Primary sclerosing cholangitis is an uncommon chronic hepatobiliary disorder, and the definitive surgical treatment for symptomatic primary sclerosing cholangitis is liver transplantation. Although some cases with primary sclerosing cholangitis treated with hepaticojejunostomy or partial hepatectomy have been reported, the indications for these procedures and their long-term results have not been well defined or studied. We present three patients with segmental primary sclerosing cholangitis, and discuss the indication of surgical treatment for primary sclerosing cholangitis excluding liver transplantation. Three patients with segmental primary sclerosing cholangitis of the common bile duct and the hepatic ducts were treated by hepaticojejunostomy with partial resection of the common bile duct. We investigated clinical features such as angiography, cholangiography, and surgical treatment outcomes. It was difficult to differentiate primary sclerosing cholangitis from a cholangioma preoperatively, despite the use of cytology, angiography, and cholangiography. Two of the three patients were preoperatively suspected to have cholangioma. Segmental primary sclerosing cholangitis was diagnosed operatively. All patients were treated hepaticojejunostomy and achieved long-term survival. Although liver transplantation is the treatment of choice for primary sclerosing cholangitis, in cases of segmental primary sclerosing cholangitis, local resection of the involved structures may be curative. Resection of a discrete lesion may provide many years of survival with a good quality of life, in some cases obviating the need for liver transplantation.

[Guest guest]

Mark, Barb, anyone?

What is segmental PSC? I've never heard of it before this article.

Thanks,

Deb in VA

AIH 1997, PSC 1998, UC 1999, Listed LTX 2001, MELD 17

> MessageSurgery for segmental primary sclerosing cholangitis.

> Barb, You dear girl, how did you ever come up with this article ?

This is definately me! and I love the words: local resection of the

involved structures may be curative.

> Thank you,

> Mark and from Las Vegas!!!

> PSC 2003, Resection 2003 (Cured?)

> Surgery for segmental primary sclerosing

cholangitis.

>

>

> Hepatogastroenterology. 2004 May.

>

>

> Surgery for segmental primary sclerosing cholangitis.

>

> Department of Surgery II, Osaka, Japan.

>

> Primary sclerosing cholangitis is an uncommon chronic

hepatobiliary disorder, and the definitive surgical treatment for

symptomatic primary sclerosing cholangitis is liver transplantation.

Although some cases with primary sclerosing cholangitis treated with

hepaticojejunostomy or partial hepatectomy have been reported, the

indications for these procedures and their long-term results have not

been well defined or studied. We present three patients with

segmental primary sclerosing cholangitis, and discuss the indication

of surgical treatment for primary sclerosing cholangitis excluding

liver transplantation. Three patients with segmental primary

sclerosing cholangitis of the common bile duct and the hepatic ducts

were treated by hepaticojejunostomy with partial resection of the

common bile duct. We investigated clinical features such as

angiography, cholangiography, and surgical treatment outcomes. It was

difficult to differentiate primary sclerosing cholangitis from a

cholangioma preoperatively, despite the use of cytology, angiography,

and cholangiography. Two of the three patients were preoperatively

suspected to have cholangioma. Segmental primary sclerosing

cholangitis was diagnosed operatively. All patients were treated

hepaticojejunostomy and achieved long-term survival. Although liver

transplantation is the treatment of choice for primary sclerosing

cholangitis, in cases of segmental primary sclerosing cholangitis,

local resection of the involved structures may be curative. Resection

of a discrete lesion may provide many years of survival with a good

quality of life, in some cases obviating the need for liver

transplantation.

>

>

>

[Guest guest]

Subject: Re: Surgery for segmental primary sclerosing

cholangitis.

Deb:

Segmental PSC is PSC that effects primarily only one lobe of the liver, it

is rare and does not necessitate that the other

lobe(s) will not ultimately become effected, but for some reason the body

just wants to attack a specific part of the liver with great vengence. When

they removed the lt lobe of my liver, and the CBD, it was at stage 3 and 4,

where as the remaining Rt lobe is at stage 1. My labs have always been

absolutely normal. The jury is out as to how long my Rt lobe will remain

homogeneous and essentially fine!

Hope this helps,

Mark

> Mark, Barb, anyone?

> What is segmental PSC? I've never heard of it before this article.

>

> Thanks,

> Deb in VA

> AIH 1997, PSC 1998, UC 1999, Listed LTX 2001, MELD 17

>

>

> > MessageSurgery for segmental primary sclerosing cholangitis.

> > Barb, You dear girl, how did you ever come up with this article ?

> This is definately me! and I love the words: local resection of the

> involved structures may be curative.

> > Thank you,

> > Mark and from Las Vegas!!!

> > PSC 2003, Resection 2003 (Cured?)

[Guest guest]

Thanks Mark - it sure does make sense. I'm wondering what stages my

two lobes are - my right has always been more effected than the left.

In fact, it is the right that is now completely blocked, and the left

is essentially doing all the work for my entire liver. Obviously, my

labs aren't normal - MELD 17 shows that, but I do find it interesting

that there is even a name for one side can getting the brunt of the

disease. Thanks again, Deb

> > > MessageSurgery for segmental primary sclerosing cholangitis.

> > > Barb, You dear girl, how did you ever come up with this

article ?

> > This is definately me! and I love the words: local resection of

the

> > involved structures may be curative.

> > > Thank you,

> > > Mark and from Las Vegas!!!

> > > PSC 2003, Resection 2003 (Cured?)