BACKGROUND & AIMS: In patients with primary sclerosing cholangitis (PSC) treated with ursodeoxycholic acid (UDCA), dominant stenoses are associated with reduced survival free of liver transplantation and the role of inflammatory bowel disease (IBD) in such patients is unclear. In the present study the influence of IBD on the outcome in patients with and without dominant stenosis has been evaluated. METHODS: In a prospective study, 171 patients were followed for up to 20 years. All patients were treated with ursodeoxycholic acid; patients with dominant stenosis in addition were treated endoscopically. RESULTS: A total of 97 out of 171 patients had or developed dominant bile duct stenoses and 96 out of 97 were treated endoscopically. In patients with dominant stenosis without IBD, no carcinoma was found whereas all six bile duct and two gallbladder carcinomas and 6/7 colo-rectal carcinomas were found in patients with dominant stenosis with IBD (p=0.012). In patients without dominant stenosis but with IBD, 1 out of 7 had colo-rectal carcinoma. In patients with dominant stenosis without IBD (n=30), actuarial survival free of liver transplantation at 18 years was 77.8% and in those with dominant stenosis and inflammatory bowel disease (n=67) it was 23.0% (p=0.045). In PSC patients without dominant stenosis and without IBD (n=21), actuarial survival free of liver transplantation at 18 years was 68.2% and in those with inflammatory bowel disease (n=53) it was 78.4% (n.s.). CONCLUSIONS: In patients without dominant stenosis, IBD had no effect on the incidence of carcinomas and survival. Only patients with dominant stenosis with additional IBD had an increased carcinoma rate. This may contribute to the reduced survival free of liver transplantation in such patients. Copyright 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
BACKGROUND & AIMS: In patients with primary sclerosing cholangitis (PSC) treated with ursodeoxycholic acid (UDCA), dominant stenoses are associated with reduced survival free of liver transplantation and the role of inflammatory bowel disease (IBD) in such patients is unclear. In the present study the influence of IBD on the outcome in patients with and without dominant stenosis has been evaluated. METHODS: In a prospective study, 171 patients were followed for up to 20 years. All patients were treated with ursodeoxycholic acid; patients with dominant stenosis in addition were treated endoscopically. RESULTS: A total of 97 out of 171 patients had or developed dominant bile duct stenoses and 96 out of 97 were treated endoscopically. In patients with dominant stenosis without IBD, no carcinoma was found whereas all six bile duct and two gallbladder carcinomas and 6/7 colo-rectal carcinomas were found in patients with dominant stenosis with IBD (p=0.012). In patients without dominant stenosis but with IBD, 1 out of 7 had colo-rectal carcinoma. In patients with dominant stenosis without IBD (n=30), actuarial survival free of liver transplantation at 18 years was 77.8% and in those with dominant stenosis and inflammatory bowel disease (n=67) it was 23.0% (p=0.045). In PSC patients without dominant stenosis and without IBD (n=21), actuarial survival free of liver transplantation at 18 years was 68.2% and in those with inflammatory bowel disease (n=53) it was 78.4% (n.s.). CONCLUSIONS: In patients without dominant stenosis, IBD had no effect on the incidence of carcinomas and survival. Only patients with dominant stenosis with additional IBD had an increased carcinoma rate. This may contribute to the reduced survival free of liver transplantation in such patients. Copyright 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Authors: M H Imam; E Sinakos; A A Gossard; K V Kowdley; V A C Luketic; M Edwyn Harrison; T McCashland; A S Befeler; D Harnois; R Jorgensen; J Petz; J Keach; A C DeCook; F Enders; K D Lindor Journal: Aliment Pharmacol Ther Date: 2011-09-29 Impact factor: 8.171
Authors: Tobias J Weismüller; Palak J Trivedi; Annika Bergquist; Mohamad Imam; Henrike Lenzen; Cyriel Y Ponsioen; Kristian Holm; Daniel Gotthardt; Martti A Färkkilä; Hanns-Ulrich Marschall; Douglas Thorburn; Rinse K Weersma; Johan Fevery; Tobias Mueller; Olivier Chazouillères; Kornelius Schulze; Konstantinos N Lazaridis; Sven Almer; Stephen P Pereira; Cynthia Levy; Andrew Mason; Sigrid Naess; Christopher L Bowlus; Annarosa Floreani; Emina Halilbasic; Kidist K Yimam; Piotr Milkiewicz; Ulrich Beuers; Dep K Huynh; Albert Pares; Christine N Manser; George N Dalekos; Bertus Eksteen; Pietro Invernizzi; Christoph P Berg; Gabi I Kirchner; Christoph Sarrazin; Vincent Zimmer; Luca Fabris; Felix Braun; Marco Marzioni; Brian D Juran; Karouk Said; Christian Rupp; Kalle Jokelainen; Maria Benito de Valle; Francesca Saffioti; Angela Cheung; Michael Trauner; Christoph Schramm; Roger W Chapman; Tom H Karlsen; Erik Schrumpf; Christian P Strassburg; Michael P Manns; Keith D Lindor; Gideon M Hirschfield; Bettina E Hansen; Kirsten M Boberg Journal: Gastroenterology Date: 2017-03-06 Impact factor: 22.682