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Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis

Department of Gastroenterology, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, Japan
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Author to whom correspondence should be addressed.
Diagnostics 2020, 10(5), 268; https://doi.org/10.3390/diagnostics10050268
Received: 15 March 2020 / Revised: 23 April 2020 / Accepted: 27 April 2020 / Published: 29 April 2020
(This article belongs to the Special Issue Endoscopic Diagnostics for Pancreatobiliary Disorders)
Primary sclerosing cholangitis (PSC) is characterized by idiopathic biliary stricture followed by progressive cholestasis and fibrosis. When diagnosing PSC, its differentiation from other types of sclerosing cholangitis and cholangiocarcinoma is necessary. The cholangioscopic findings of PSC have not been investigated sufficiently. PSC and IgG4-related sclerosing cholangitis are difficult to distinguish by peroral cholangioscopy (POCS), but POCS is useful for excluding cholangiocarcinoma. POCS findings vary according to the condition and stage of disease. In the active phase, findings such as mucosal erythema, ulceration, fibrinous white exudate, and an irregular surface are observed and may reflect strong inflammation in the biliary epithelium. On the other hand, findings such as scarring, pseudodiverticula, and bile duct stenosis appear in the chronic phase and may reflect fibrosis and stenosis resulting from repeated inflammation. Observation of inside the bile duct by POCS might confirm the current PSC activity. Because POCS offers not only information regarding the diagnosis of PSC and PSC-associated cholangiocarcinoma but also the current statuses of biliary inflammation and stenosis, POCS could significantly contribute to the diagnosis and treatment of PSC once the characteristic findings of PSC are confirmed by future studies. View Full-Text
Keywords: primary sclerosing cholangitis; cholangioscopy; IgG4-related sclerosing cholangitis; cholangiocarcinoma; scarring; pseudodiverticula; active phase; chronic phase primary sclerosing cholangitis; cholangioscopy; IgG4-related sclerosing cholangitis; cholangiocarcinoma; scarring; pseudodiverticula; active phase; chronic phase
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MDPI and ACS Style

Fujisawa, T.; Ushio, M.; Takahashi, S.; Yamagata, W.; Takasaki, Y.; Suzuki, A.; Okawa, Y.; Ochiai, K.; Tomishima, K.; Ishii, S.; Saito, H.; Isayama, H. Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis. Diagnostics 2020, 10, 268. https://doi.org/10.3390/diagnostics10050268

AMA Style

Fujisawa T, Ushio M, Takahashi S, Yamagata W, Takasaki Y, Suzuki A, Okawa Y, Ochiai K, Tomishima K, Ishii S, Saito H, Isayama H. Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis. Diagnostics. 2020; 10(5):268. https://doi.org/10.3390/diagnostics10050268

Chicago/Turabian Style

Fujisawa, Toshio; Ushio, Mako; Takahashi, Sho; Yamagata, Wataru; Takasaki, Yusuke; Suzuki, Akinori; Okawa, Yoshihiro; Ochiai, Kazushige; Tomishima, Ko; Ishii, Shigeto; Saito, Hiroaki; Isayama, Hiroyuki. 2020. "Role of Peroral Cholangioscopy in the Diagnosis of Primary Sclerosing Cholangitis" Diagnostics 10, no. 5: 268. https://doi.org/10.3390/diagnostics10050268

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