The authors who follow up on a long-term basis a group of 17 patients with primary sclerotizing cholangoitis, incl. three who had a successful transplantation of the liver, submit their ten-year results of a retrospective uncontrolled study using endoscopic drainage of the bilary pathways in these patients. Based on diagnostic ERRCP with a finding of symptomatic stenosis of the extrahepatic biliary pathways drainage with plastic stents was indicated in 6 patients and implemented seventeen times with a mean period per drainage of 18 days. The effectiveness of the drainage procedures was evaluated according to laboratory signs of cholestasis and morhology of check-up ERCP. Only in one patient it was not possible to implement the drainage because of repeated intolerance of plastic drains during the first 24 hours after their insertion. The longest period of implantation of a stent was 69 days, the shortest 24 hours. In the remainder of the group the main complications were acute cholangoitis and obturation of the drains always associated with a period of insertion longer than 21 days. During a longer interval of implantation of one plastic stent the authors observed also marked formation of sludge and in some cases they found during a check-up ERCP a condition which they described as progression of stenotic changes beyond the section of drainage. Effective drainage led to a decline of cholestasis incl. disappearance of jaundice on average for six months after the procedure. Based on their own experience and with regard to data in the literature published abroad the authors reach the conclusion that drainage in patients with primary sclerotizing cholangoitis may, considering contemporary technical possibilities, potentiate in addition to a positive dilatation effect of stenoses, pathognomic changes in the bile ducts. Therefore they recommend to use plastic endoscopic drainages in this indication as the method of second choice in symptomatic stenoses if previous endoscopic dilatations are not sufficiently effective. Plastic drains should be inserted for a period longer than 9 days. When selecting the drain the authors recommend preference of the pigtail type to drains with spikes.

        Key words: primary sclerotizing cholangoitis (PSC) – endoscopic retrograde cholangiopancreaticography (ERCP)