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Endoscopy in the management of primary sclerosing cholangitis

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Abstract

Primary sclerosing cholangitis (PSC) is a chronic, cholestatic liver condition characterized by progressive fibrosis and destruction of the intra-and extrahepatic biliary tree. PSC has a clear association with inflammatory bowel disease and is often progressive, leading to cirrhosis and end-stage liver failure. For many patients, liver transplantation offers the only hope of long-term survival. No effective medical treatment exists, and therapy is often aimed at treating complications of the disorder, including dominant biliary strictures, which may cause symptomatic jaundice, cholangitis, and pruritus. Studies on endoscopic therapy (eg, biliary dilation and/or stent insertion) have shown favorable results, although most studies have been small, retrospective, and uncontrolled. Up to 20% of patients with PSC develop cholangiocarcinoma; however, distinguishing between cholangiocarcinoma and benign strictures can be difficult. Ideally, randomized trials are required to determine the safest and most effective endoscopic management for symptomatic dominant strictures.

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  1. Division of Gastroenterology, St Paul’s Hospital, 1144 Burrard Street, Vancouver, British Columbia, Canada

    Mark McLoughlin

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  1. Mark McLoughlin
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  2. Robert Enns
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Correspondence to Mark McLoughlin.

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McLoughlin, M., Enns, R. Endoscopy in the management of primary sclerosing cholangitis. Curr Gastroenterol Rep 10, 177–185 (2008). https://doi.org/10.1007/s11894-008-0040-9

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