To the Editor:
The article by Baluyut et al.
1
is a report of experience in treating patients with primary sclerosing cholangitis (PSC) by using endoscopic techniques. Although the authors referred to a number of previous reports on the subject, they failed to refer to a seminal report we published in 1993.2
This was a review of the literature and a report of a large, ongoing series of patients with PSC that we treated with endoscopic techniques. Although our study was not randomized but evidenced-based, we arrived at the same conclusions as Baluyut et al., only much earlier; patients with PSC treated endoscopically benefit from our treatment schema. Our data were subjected to statistical analyses and reached significance for two biochemical indices, serum transaminase and alkaline phosphatase, supporting our conclusion and the more optimistic statement that endoscopic therapy could prolong the lives of patients with PSC and could postpone liver transplantation.Our study also included patients treated with different modalities, varying from balloon dilation of dominant strictures to insertion of endoprostheses by using the largest caliber stent that could be placed. A cohort of our patients received a trial of drug therapy: ursodeoxycholic acid taken orally. We reviewed our and other investigators' experience by using modalities that included the unique technique of long-term infusion of antibiotics, corticosteroids, and saline solution delivered through a nasobiliary tube, a novel treatment modality that has not been reported subsequently.
References
- Impact of endoscopic therapy on the survival of patients with primary sclerosing cholangitis.Gastrointest Endosc. 2001; 53: 308-312
- Endoscopic management of primary sclerosing cholangitis: review and report of an open series.Am J Gastroenterol. 1993; 88: 2000-2009
Article info
Identification
Copyright
© 2001 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
