Radiologic regression of primary sclerosing cholangitis following combination therapy with an endoprosthesis and ursodeoxycholic acid.

Bile duct strictures seen in patients with primary sclerosing cholangitis are generally considered irreversible. Oral ursodeoxycholic acid therapy has been shown to improve symptoms and biochemical abnormalities, as well as reverse intrahepatic alterations in patients with biliary strictures. Endoscopic therapy also has been effective in relieving symptoms, improving biochemical and radiologic abnormalities, and preventing recurrent cholangitis in patients with primary sclerosing cholangitis. We report a case in which a combination of prolonged endoscopic stenting and oral bile acid therapy resulted in regression of cholangiographic changes and produced a sustained clinical remission.