| セッション情報 |
International Session3(消化器内視鏡学会・消化器病学会合同)
IgG4-related disease and endoscopy
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| タイトル |
消IS3-4：The role of peroral video cholangioscopy in IgG4-related sclerosing cholangitis
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| 演者 |
T. Tsuchiya（Department of Gastroenterology and Hepatology, Tokyo Medical University） |
| 共同演者 |
T. Itoi（Department of Gastroenterology and Hepatology, Tokyo Medical University）, T. Kamisawa（Department of Internal Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital） |
| 抄録 |
Background: The cholangioscopic features of IgG4-related sclerosing cholangitis (IgG4-SC) remain undefined. It is well-known that IgG4-SC often shows stenosis of the distal and hilar bile duct. Thus, differentiation between IgG4-SC and cholangiocarcinoma is mandatory.The aim of this study is to clarify these endoscopic features using peroral video cholangioscopy (PVCS) in IgG4-SC patients. Patients and Methods: PVCS was performed in 13 patients at four tertiary referral centers between February 2006 and August 2011. Endoscopic findings of IgG4-SC were compared with cholangiocarcinomas and primary sclerosing cholangitis (PSC).Results: The most frequent findings on PVCS in IgG4-SC patients were dilated (62%) and tortuous (69%) vessels, and absence of partially enlarged and fused vessels. The incidence of dilated and tortuous vessels was significantly higher in IgG4-SC patients than in PSC patients. Scarring and pseudodiverticula were found significantly more often in PSC patients than in IgG4-SC patients. It was difficult to differentiate between IgG4-SC and certain cholangiocarcinomas, which show only dilated and tortuous vessels without partially enlarged and fused vessels. PVCS performed after corticosteroid therapy showed improvement in bile duct stenosis, dilated, tortuous or partially enlarged vessels, and friability improved in all patients with IgG4-SC. Conclusion: PVCS was useful in differentiating IgG4-SC from PSC. In addition, monitoring the patterns of proliferative vessels on PVCS may be useful to differentiate IgG4-SC from cholangiocarcinomas. |
| 索引用語 |
IgG4-SC, POCS |
