【医脉通•指南】2015+ACG临床指南：原发性硬化性胆管炎.pdfVIP

nature publishing group PRACTICE GUIDELINES 1 see related editorial on page x ACG Clinical Guideline: Primary Sclerosing Cholangitis Keith D. Lindor , MD, FACG1 , 2 , Kris V. Kowdley , MD, FACG3 and M. Edwyn Harrison , MD2 Primary sclerosing cholangitis is a chronic cholestatic liver disease that can shorten life and may require liver transplantation. The cause is unknown, although it is commonly associated with colitis. There is no approved or proven therapy, although ursodeoxycholic acid is used by many on an empiric basis. Complications including portal hypertension, fat-soluble vitamin de? ciency, metabolic bone diseases, and development of cancers of the bile duct or colon can occur. Am J Gastroenterol advance online publication, 14 April 2015; doi:10.1038/ajg.2015.112 PREAMBLE be reviewed at an established time and indicated at publication, Th e writing group was invited by the Practice Parameters Com- to assure continued validity. mittee and the Board of the Trustees of the American College of Gastroenterology to develop a practice guideline on primary scle- rosing cholangitis (PSC). INTRODUCTION Guidelines for clinical practice are intended to indicate Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver preferred approaches to medical problems as established by and biliary tract disease that has a highly variable natural history scientifi cally valid research. Double-blind, placebo-controlled ( 1 ). Th e pathogenesis of the disorder remains elusive, although studies are preferable, but reports and expert review arti- the complications of the disease are a direct result of fi brosis and cles are also used in a thorough review of the literature con- strictures involving intra and extrahepatic bile ducts (1 ). PSC ducted through the National Library of Medic