Abstract：
OBJECTIVE: Endoscopic retrograde cholangiopancreatography (ERCP) may help detect cholangiocarcinoma in patients with primary sclerosing cholangitis (PSC), but it may be associated with complications. This study was aimed at determining the prognostic impact of ERCP on patients with PSC without cholangitis.
METHODS: Patients with PSC without cholangitis were divided into two groups: those who underwent ERCP within three years after diagnosis (ERCP-performed group) and those who did not (non-ERCP group). These groups were compared in terms of clinical outcomes (liver-related death or liver transplantation, endoscopic treatment requirement and repeated cholangitis) and the composite outcome.
RESULTS: Of 99 patients with PSC with detailed medical history, 49 were included in the ERCP-performed group and 21 in the non-ERCP group. In Kaplan-Meier analysis, the non-ERCP group was less likely to achieve the three outcomes and the composite outcome, showing statistical significance (endoscopic treatment requirement; p = 0.017 and composite outcome; p = 0.014). A Cox proportional hazards model indicated that ERCP in the asymptomatic state was a significant predictor of endoscopic treatment requirement (hazard ratio [HR]: 4.37, 95% confidence interval [CI]: 1.03-18.59) and the composite outcome (HR: 4.54, 95% CI: 1.07-19.28).
CONCLUSIONS: ERCP in patients with PSC without cholangitis is likely to require further endoscopic treatment and may be associated with poor prognosis.
METHODS: Patients with PSC without cholangitis were divided into two groups: those who underwent ERCP within three years after diagnosis (ERCP-performed group) and those who did not (non-ERCP group). These groups were compared in terms of clinical outcomes (liver-related death or liver transplantation, endoscopic treatment requirement and repeated cholangitis) and the composite outcome.
RESULTS: Of 99 patients with PSC with detailed medical history, 49 were included in the ERCP-performed group and 21 in the non-ERCP group. In Kaplan-Meier analysis, the non-ERCP group was less likely to achieve the three outcomes and the composite outcome, showing statistical significance (endoscopic treatment requirement; p = 0.017 and composite outcome; p = 0.014). A Cox proportional hazards model indicated that ERCP in the asymptomatic state was a significant predictor of endoscopic treatment requirement (hazard ratio [HR]: 4.37, 95% confidence interval [CI]: 1.03-18.59) and the composite outcome (HR: 4.54, 95% CI: 1.07-19.28).
CONCLUSIONS: ERCP in patients with PSC without cholangitis is likely to require further endoscopic treatment and may be associated with poor prognosis.
摘要：
目的：内镜逆行胰胆管造影术（ERCP）可能有助于检测原发性硬化性胆管炎（PSC）患者的胆管癌，但它可能与并发症有关。这项研究旨在确定ERCP对无胆管炎的PSC患者的预后影响。
方法：将无胆管炎的PSC患者分为两组：在诊断后三年内接受ERCP的患者（进行ERCP组）和未接受ERCP的患者（非ERCP组）。比较这些组的临床结果（肝脏相关死亡或肝移植，内镜治疗要求和反复胆管炎）和复合结局。
结果：在99例有详细病史的PSC患者中，ERCP组包括49例，非ERCP组包括21例。在Kaplan-Meier分析中,非ERCP组不太可能达到三个结局和复合结局，显示统计学意义（内窥镜治疗要求；p=0.017和复合结果；p=0.014）。Cox比例风险模型表明，无症状状态下的ERCP是内窥镜治疗要求（风险比[HR]：4.37，95％置信区间[CI]：1.03-18.59）和复合结局（HR：4.54，95％CI：1.07-19.28）的重要预测指标。
结论：无胆管炎的PSC患者的ERCP可能需要进一步的内镜治疗，并且可能与不良预后有关。
方法：将无胆管炎的PSC患者分为两组：在诊断后三年内接受ERCP的患者（进行ERCP组）和未接受ERCP的患者（非ERCP组）。比较这些组的临床结果（肝脏相关死亡或肝移植，内镜治疗要求和反复胆管炎）和复合结局。
结果：在99例有详细病史的PSC患者中，ERCP组包括49例，非ERCP组包括21例。在Kaplan-Meier分析中,非ERCP组不太可能达到三个结局和复合结局，显示统计学意义（内窥镜治疗要求；p=0.017和复合结果；p=0.014）。Cox比例风险模型表明，无症状状态下的ERCP是内窥镜治疗要求（风险比[HR]：4.37，95％置信区间[CI]：1.03-18.59）和复合结局（HR：4.54，95％CI：1.07-19.28）的重要预测指标。
结论：无胆管炎的PSC患者的ERCP可能需要进一步的内镜治疗，并且可能与不良预后有关。
