Primary sclerosing cholangitis : liver transplantation or biliary surgery
Identifieur interne : 000895 ( PascalFrancis/Checkpoint ); précédent : 000894; suivant : 000896Primary sclerosing cholangitis : liver transplantation or biliary surgery
Auteurs : O. Farges [France] ; B. Malassagne ; M. Sebagh ; H. BismuthSource :
- Surgery [ 0039-6060 ] ; 1995.
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- Pascal (Inist)
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Abstract
Background. Little information is available on the indecations for, and the efficacy and timing of, liver transplantation in patients with primary sclerosing cholangitis (PSC). This issue is particularly relevant because prolonged survival has been reported in patients who do not undergo transplantation. Methods. Long-term results of therapeutic interventions including lever transplantateon was assessed in a representative series of 51 patients. Patient survival was compared with that expected from prognostic models. Results. Actuarial symptom free survival rate in patients treated by nontransplantation biliary surgery (n=23) was 35% at 10 years. Actuarial survival rate from onset of PSC (56% at 10 years) was identical to that expected from the prognostic model. Actuarial patient (n=28) survival rate years after transplantation was greater than that expected from prognostic models (89% versus 31%; p<0.001). Previous abdominal surgery was associated with an increased in-hospital mortality rate (p<0.05). Cumulative actuarial incidence of cancer 5 and 10 years after the onset of PSC was 13% and 31%, respectevely. Conclusions. Liver transplantation improves the prognosis of patients with PSC. Failure to edentify patients who well benefit from nontransplantation therapeutic interventions or in whom a cancer will develop, and the risk associated with previous abdomenal surgery, suggest that liver transplantation should be indicated early after onset of symptoms
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Primary sclerosing cholangitis : liver transplantation or biliary surgery</title><author><name sortKey="Farges, O" sort="Farges, O" uniqKey="Farges O" first="O." last="Farges">O. Farges</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Hepatobiliary cent., hepatobiliary surgery liver transplantation cent.</s1><s2>Villejuif</s2><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>hepatobiliary surgery liver transplantation cent.</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Paul Brousse hosp., dep. pathology</s1><s2>Villejuif</s2><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>dep. pathology</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Univ. Paris XI, fac. medicine Kremlin-Bicêtre, liver surgery res. group</s1><s2>Villejuif</s2><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>liver surgery res. group</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Malassagne, B" sort="Malassagne, B" uniqKey="Malassagne B" first="B." last="Malassagne">B. Malassagne</name></author><author><name sortKey="Sebagh, M" sort="Sebagh, M" uniqKey="Sebagh M" first="M." last="Sebagh">M. Sebagh</name></author><author><name sortKey="Bismuth, H" sort="Bismuth, H" uniqKey="Bismuth H" first="H." last="Bismuth">H. Bismuth</name></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">95-0163249</idno><date when="1995">1995</date><idno type="stanalyst">PASCAL 95-0163249 INIST</idno><idno type="RBID">Pascal:95-0163249</idno><idno type="wicri:Area/PascalFrancis/Corpus">000920</idno><idno type="wicri:Area/PascalFrancis/Curation">000955</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000895</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000895</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Primary sclerosing cholangitis : liver transplantation or biliary surgery</title><author><name sortKey="Farges, O" sort="Farges, O" uniqKey="Farges O" first="O." last="Farges">O. Farges</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Hepatobiliary cent., hepatobiliary surgery liver transplantation cent.</s1><s2>Villejuif</s2><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>hepatobiliary surgery liver transplantation cent.</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Paul Brousse hosp., dep. pathology</s1><s2>Villejuif</s2><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>dep. pathology</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Univ. Paris XI, fac. medicine Kremlin-Bicêtre, liver surgery res. group</s1><s2>Villejuif</s2><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>liver surgery res. group</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Malassagne, B" sort="Malassagne, B" uniqKey="Malassagne B" first="B." last="Malassagne">B. Malassagne</name></author><author><name sortKey="Sebagh, M" sort="Sebagh, M" uniqKey="Sebagh M" first="M." last="Sebagh">M. Sebagh</name></author><author><name sortKey="Bismuth, H" sort="Bismuth, H" uniqKey="Bismuth H" first="H." last="Bismuth">H. Bismuth</name></author></analytic><series><title level="j" type="main">Surgery</title><title level="j" type="abbreviated">Surgery</title><idno type="ISSN">0039-6060</idno><imprint><date when="1995">1995</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Surgery</title><title level="j" type="abbreviated">Surgery</title><idno type="ISSN">0039-6060</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Choice</term><term>Gallbladder</term><term>Human</term><term>Liver</term><term>Primary</term><term>Result</term><term>Sclerosing cholangitis</term><term>Surgery</term><term>Transplantation</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Angiocholite sténosante</term><term>Primaire</term><term>Choix</term><term>Traitement</term><term>Chirurgie</term><term>Vésicule biliaire</term><term>Transplantation</term><term>Foie</term><term>Résultat</term><term>Homme</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background. Little information is available on the indecations for, and the efficacy and timing of, liver transplantation in patients with primary sclerosing cholangitis (PSC). This issue is particularly relevant because prolonged survival has been reported in patients who do not undergo transplantation. Methods. Long-term results of therapeutic interventions including lever transplantateon was assessed in a representative series of 51 patients. Patient survival was compared with that expected from prognostic models. Results. Actuarial symptom free survival rate in patients treated by nontransplantation biliary surgery (n=23) was 35% at 10 years. Actuarial survival rate from onset of PSC (56% at 10 years) was identical to that expected from the prognostic model. Actuarial patient (n=28) survival rate years after transplantation was greater than that expected from prognostic models (89% versus 31%; p<0.001). Previous abdominal surgery was associated with an increased in-hospital mortality rate (p<0.05). Cumulative actuarial incidence of cancer 5 and 10 years after the onset of PSC was 13% and 31%, respectevely. Conclusions. Liver transplantation improves the prognosis of patients with PSC. Failure to edentify patients who well benefit from nontransplantation therapeutic interventions or in whom a cancer will develop, and the risk associated with previous abdomenal surgery, suggest that liver transplantation should be indicated early after onset of symptoms</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0039-6060</s0></fA01><fA02 i1="01"><s0>SURGAZ</s0></fA02><fA03 i2="1"><s0>Surgery</s0></fA03><fA05><s2>117</s2></fA05><fA06><s2>2</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Primary sclerosing cholangitis : liver transplantation or biliary surgery</s1></fA08><fA11 i1="01" i2="1"><s1>FARGES (O.)</s1></fA11><fA11 i1="02" i2="1"><s1>MALASSAGNE (B.)</s1></fA11><fA11 i1="03" i2="1"><s1>SEBAGH (M.)</s1></fA11><fA11 i1="04" i2="1"><s1>BISMUTH (H.)</s1></fA11><fA14 i1="01"><s1>Hepatobiliary cent., hepatobiliary surgery liver transplantation cent.</s1><s2>Villejuif</s2><s3>FRA</s3></fA14><fA14 i1="02"><s1>Paul Brousse hosp., dep. pathology</s1><s2>Villejuif</s2><s3>FRA</s3></fA14><fA14 i1="03"><s1>Univ. Paris XI, fac. medicine Kremlin-Bicêtre, liver surgery res. group</s1><s2>Villejuif</s2><s3>FRA</s3></fA14><fA20><s1>146-155</s1></fA20><fA21><s1>1995</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>2063</s2><s5>354000059363990040</s5></fA43><fA44><s0>0000</s0></fA44><fA45><s0>43 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>95-0163249</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Surgery</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Background. Little information is available on the indecations for, and the efficacy and timing of, liver transplantation in patients with primary sclerosing cholangitis (PSC). This issue is particularly relevant because prolonged survival has been reported in patients who do not undergo transplantation. Methods. Long-term results of therapeutic interventions including lever transplantateon was assessed in a representative series of 51 patients. Patient survival was compared with that expected from prognostic models. Results. Actuarial symptom free survival rate in patients treated by nontransplantation biliary surgery (n=23) was 35% at 10 years. Actuarial survival rate from onset of PSC (56% at 10 years) was identical to that expected from the prognostic model. Actuarial patient (n=28) survival rate years after transplantation was greater than that expected from prognostic models (89% versus 31%; p<0.001). Previous abdominal surgery was associated with an increased in-hospital mortality rate (p<0.05). Cumulative actuarial incidence of cancer 5 and 10 years after the onset of PSC was 13% and 31%, respectevely. Conclusions. Liver transplantation improves the prognosis of patients with PSC. Failure to edentify patients who well benefit from nontransplantation therapeutic interventions or in whom a cancer will develop, and the risk associated with previous abdomenal surgery, suggest that liver transplantation should be indicated early after onset of symptoms</s0></fC01><fC02 i1="01" i2="X"><s0>002B25G03</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Angiocholite sténosante</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Sclerosing cholangitis</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Angiocolitis estenosante</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Primaire</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Primary</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Primario</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Choix</s0><s5>04</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Choice</s0><s5>04</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Elección</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Traitement</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Treatment</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="GER"><s0>Aufbereiten</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Tratamiento</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Chirurgie</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Surgery</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Cirugía</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Vésicule biliaire</s0><s5>07</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Gallbladder</s0><s5>07</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Vesícula biliar</s0><s5>07</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Transplantation</s0><s5>08</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Transplantation</s0><s5>08</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Trasplantación</s0><s5>08</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Foie</s0><s5>09</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Liver</s0><s5>09</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Hígado</s0><s5>09</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Résultat</s0><s5>17</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Result</s0><s5>17</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Resultado</s0><s5>17</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Homme</s0><s5>19</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Human</s0><s5>19</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Hombre</s0><s5>19</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Appareil digestif pathologie</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Digestive diseases</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Aparato digestivo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Voie biliaire pathologie</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Biliary tract disease</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Vía biliar patología</s0><s5>38</s5></fC07><fN21><s1>095</s1></fN21></pA></standard></inist><affiliations><list><country><li>France</li></country></list><tree><noCountry><name sortKey="Bismuth, H" sort="Bismuth, H" uniqKey="Bismuth H" first="H." last="Bismuth">H. Bismuth</name><name sortKey="Malassagne, B" sort="Malassagne, B" uniqKey="Malassagne B" first="B." last="Malassagne">B. Malassagne</name><name sortKey="Sebagh, M" sort="Sebagh, M" uniqKey="Sebagh M" first="M." last="Sebagh">M. Sebagh</name></noCountry><country name="France"><noRegion><name sortKey="Farges, O" sort="Farges, O" uniqKey="Farges O" first="O." last="Farges">O. Farges</name></noRegion><name sortKey="Farges, O" sort="Farges, O" uniqKey="Farges O" first="O." last="Farges">O. Farges</name><name sortKey="Farges, O" sort="Farges, O" uniqKey="Farges O" first="O." last="Farges">O. Farges</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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