title: Dominant strictures in patients with primary sclerosing cholangitis.
abstract: BACKGROUND
  Repeat endoscopic dilatations of dominant strictures (DS) have been reported to be of benefit in patients with primary sclerosing cholangitis (PSC). We aimed to determine the prevalence of DS in patients with PSC and the spontaneous course of ALP and bilirubin, up to a year from diagnosis in patients with and without DS.
  
  
  METHODS
  Cholangiographies from 125 patients with PSC were reevaluated. DS was defined as a stenosis < or =1.5 mm in diameter of the common bile duct (CBD) and/or < or = 1.0 mm of right (RHD) or left hepatic duct (LHD).
  
  
  RESULTS
  A dominant stricture in common bile duct and/or right hepatic duct or left hepatic duct was present in 56 out of 125 (45%) patients. Mean values for alkaline phosphatase were 16 and 15.2 microkat/L and bilirubin values were 42 and 35 micromol/L before cholangiography in patients with and without DS, respectively (NS). The change in ALP and bilirubin observed from the precholangiographic value up to 2 and 12 months afterward was not significantly different in those with and without DS.
  
  
  CONCLUSIONS
  Cholestasis in patients with PSC does not seem to be related to the presence of DS. Endoscopic therapy of DS should not be routinely undertaken and randomized studies are needed to clarify its potential benefits.
authors.affiliation: Department of Internal Medicine, Section of Gastroenterology and Hepatology, Sahlgrenska University, Gothenburg, Sweden.
authors.forename: Einar
authors.initials: E
authors.lastname: Björnsson
authors.forename: Joachim
authors.initials: J
authors.lastname: Lindqvist-Ottosson
authors.forename: Mats
authors.initials: M
authors.lastname: Asztely
authors.forename: Rolf
authors.initials: R
authors.lastname: Olsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D001649:Bile Duct Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D015209:Cholangitis, Sclerosing / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013997:Time Factors
chemical_list: D000469:Alkaline Phosphatase