Endoscopy 2017; 49(06): 588-608
DOI: 10.1055/s-0043-107029
Guideline
© Georg Thieme Verlag KG Stuttgart · New York

Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline

Lars Aabakken
1   GI Endoscopy, Rikshospitalet University Hospital, Hospital, and Faculty of Medicine, University of Oslo,Oslo, Norway
,
Tom H. Karlsen
2   Norwegian PSC Research Center and Section for Gastroenterology, Department of Transplantation Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
,
Jörg Albert
3   Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Robert-Bosch-Krankenhaus, Stuttgart, Germany
,
Marianna Arvanitakis
4   Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
,
Olivier Chazouilleres
5   Service d’Hépatologie, Hôpital Saint-Antoine, Assistance Publique – Hôpitaux de Paris, Centre de référence des maladies inflammatoires du foie et des voies biliaires, Filière Maladies Rares du Foie de l’Adulte et de l’Enfant (FILFOIE), UPMC UNIV Paris 06, France
,
Jean-Marc Dumonceau
6   Gedyt Endoscopy Center, Buenos Aires, Argentina
,
Martti Färkkilä
7   Department of Gastroenterology, Helsinki University Central Hospital, Helsinki, Finland
,
Peter Fickert
8   Research Unit for Experimental and Molecular Hepatology, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Austria
,
Gideon M. Hirschfield
9   National Institute for Health Research (NIHR), Birmingham Liver Biomedical Research Unit (BRU), and Centre for Liver Research, University of Birmingham, Birmingham, United Kingdom
,
Andrea Laghi
10   Pathological Sciences, Sapienza-University, Rome, Italy
,
Marco Marzioni
11   Clinic of Gastroenterology and Hepatology, Università Politecnica delle Marche – Ospedali Riuniti University Hospital, Ancona, Italy
,
Michael Fernandez
4   Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
,
Stephen P. Pereira
12   Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
,
Jürgen Pohl
13   Department of Gastroenterology and Interventional Endoscopy, Klinikum Friedrichshain, Berlin, Germany
,
Jan-Werner Poley
14   Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
,
Cyriel Y. Ponsioen
15   Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
,
Christoph Schramm
16   Department of Medicine I and Martin Zeitz Centre for Rare Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
Fredrik Swahn
17   Center for Digestive Diseases, Karolinska University Hospital and Division of Surgery, CLINTEC, Karolinska Institute, Stockholm, Sweden
,
Andrea Tringali
18   Digestive Endoscopy Unit, Catholic University, Rome, Italy
,
Cesare Hassan
19   Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 April 2017 (online)

MAIN RECOMMENDATIONS

1 ESGE/EASL recommend that, as the primary diagnostic modality for PSC, magnetic resonance cholangiography (MRC) should be preferred over endoscopic retrograde cholangiopancreatography (ERCP).

Moderate quality evidence, strong recommendation.

2 ESGE/EASL suggest that ERCP can be considered if MRC plus liver biopsy is equivocal or contraindicated in patients with persisting clinical suspicion of PSC. The risks of ERCP have to be weighed against the potential benefit with regard to surveillance and treatment recommendations.

Low quality evidence, weak recommendation.

6 ESGE/EASL suggest that, in patients with an established diagnosis of PSC, MRC should be considered before therapeutic ERCP.

Weak recommendation, low quality evidence.

7 ESGE/EASL suggest performing endoscopic treatment with concomitant ductal sampling (brush cytology, endobiliary biopsies) of suspected significant strictures identified at MRC in PSC patients who present with symptoms likely to improve following endoscopic treatment.

Strong recommendation, low quality evidence.

9 ESGE/EASL recommend weighing the anticipated benefits of biliary papillotomy/sphincterotomy against its risks on a case-by-case basis.

Strong recommendation, moderate quality evidence.

Biliary papillotomy/sphincterotomy should be considered especially after difficult cannulation.

Strong recommendation, low quality evidence.

16 ESGE/EASL suggest routine administration of prophylactic antibiotics before ERCP in patients with PSC.

Strong recommendation, low quality evidence.

17 EASL/ESGE recommend that cholangiocarcinoma (CCA) should be suspected in any patient with worsening cholestasis, weight loss, raised serum CA19-9, and/or new or progressive dominant stricture, particularly with an associated enhancing mass lesion.

Strong recommendation, moderate quality evidence.

19 ESGE/EASL recommend ductal sampling (brush cytology, endobiliary biopsies) as part of the initial investigation for the diagnosis and staging of suspected CCA in patients with PSC.

Strong recommendation, high quality evidence.

 
  • References

  • 1 Olsson R, Danielsson A, Jarnerot G. et al. Prevalence of primary sclerosing cholangitis in patients with ulcerative colitis. Gastroenterology 1991; 100: 1319-1323
  • 2 Lunder AK, Hov JR, Borthne A. et al. Prevalence of sclerosing cholangitis, detected by magnetic resonance cholangiography, in patients with long-term inflammatory bowel disease. Gastroenterology 2016; 151: 660-669.e4
  • 3 Boonstra K, van Erpecum KJ, van Nieuwkerk KM. et al. Primary sclerosing cholangitis is associated with a distinct phenotype of inflammatory bowel disease. Inflamm Bowel Dis 2012; 18: 2270-2276
  • 4 O’Toole A, Alakkari A, Keegan D. et al. Primary sclerosing cholangitis and disease distribution in inflammatory bowel disease. Clin Gastroenterol Hepatol 2012; 10: 439-441
  • 5 Loftus Jr. EV, Harewood GC, Loftus CG. et al. PSC-IBD: a unique form of inflammatory bowel disease associated with primary sclerosing cholangitis. Gut 2005; 54: 91-96
  • 6 EASL Clinical Practice Guidelines: management of cholestatic liver diseases. J Hepatol 2009; 51: 237-267
  • 7 Atkins D, Eccles M, Flottorp S. et al. Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group. BMC Health Serv Res 2004; 4: 38
  • 8 Chapman R, Fevery J, Kalloo A. et al. Diagnosis and management of primary sclerosing cholangitis. Hepatology 2010; 51: 660-678
  • 9 Berstad AE, Aabakken L, Smith HJ. et al. Diagnostic accuracy of magnetic resonance and endoscopic retrograde cholangiography in primary sclerosing cholangitis. Clin Gastroenterol Hepatol 2006; 4: 514-520
  • 10 Moff SL, Kamel IR, Eustace J. et al. Diagnosis of primary sclerosing cholangitis: a blinded comparative study using magnetic resonance cholangiography and endoscopic retrograde cholangiography. Gastrointest Endosc 2006; 64: 219-223
  • 11 Philpott C, Rosenbaum J, Moon A. et al. Paediatric MRCP: 10 year experience with 195 patients. Eur J Radiol 2013; 82: 699-706
  • 12 Rossi G, Sciveres M, Maruzzelli L. et al. Diagnosis of sclerosing cholangitis in children: blinded, comparative study of magnetic resonance versus endoscopic cholangiography. Clin Res Hepatol Gastroenterol 2013; 37: 596-601
  • 13 Dave M, Elmunzer BJ, Dwamena BA. et al. Primary sclerosing cholangitis: meta-analysis of diagnostic performance of MR cholangiopancreatography. Radiology 2010; 256: 387-396
  • 14 Meagher S, Yusoff I, Kennedy W. et al. The roles of magnetic resonance and endoscopic retrograde cholangiopancreatography (MRCP and ERCP) in the diagnosis of patients with suspected sclerosing cholangitis: a cost–effectiveness analysis. Endoscopy 2007; 39: 222-228
  • 15 Talwalkar JA, Angulo P, Johnson CD. et al. Cost-minimization analysis of MRC versus ERCP for the diagnosis of primary sclerosing cholangitis. Hepatology 2004; 40: 39-45
  • 16 Kalaitzakis E, Levy M, Kamisawa T. et al. Endoscopic retrograde cholangiography does not reliably distinguish IgG4-associated cholangitis from primary sclerosing cholangitis or cholangiocarcinoma. Clin Gastroenterol Hepatol 2011; 9: 800-803 e2
  • 17 Ruiz A, Lemoinne S, Carrat F. et al. Radiologic course of primary sclerosing cholangitis: assessment by three-dimensional magnetic resonance cholangiography and predictive features of progression. Hepatology 2014; 59: 242-250
  • 18 Weber C, Kuhlencordt R, Grotelueschen R. et al. Magnetic resonance cholangiopancreatography in the diagnosis of primary sclerosing cholangitis. Endoscopy 2008; 40: 739-745
  • 19 Eaton JE, Talwalkar JA, Lazaridis KN. et al. Pathogenesis of primary sclerosing cholangitis and advances in diagnosis and management. Gastroenterology 2013; 145: 521-536
  • 20 Li-Yeng C, Goldberg HI. Sclerosing cholangitis: broad spectrum of radiographic features. Gastrointest Radiol 1984; 9: 39-47
  • 21 Majoie CB, Reeders JW, Sanders JB. et al. Primary sclerosing cholangitis: a modified classification of cholangiographic findings. AJR Am J Roentgenol 1991; 157: 495-497
  • 22 Ponsioen CY, Vrouenraets SM, Prawirodirdjo W. et al. Natural history of primary sclerosing cholangitis and prognostic value of cholangiography in a Dutch population. Gut 2002; 51: 562-566
  • 23 Ponsioen CY, Reitsma JB, Boberg KM. et al. Validation of a cholangiographic prognostic model in primary sclerosing cholangitis. Endoscopy 2010; 42: 742-747
  • 24 Craig DA, MacCarty RL, Wiesner RH. et al. Primary sclerosing cholangitis: value of cholangiography in determining the prognosis. AJR Am J Roentgenol 1991; 157: 959-964
  • 25 Abdalian R, Heathcote EJ. Sclerosing cholangitis: a focus on secondary causes. Hepatology 2006; 44: 1063-1074
  • 26 Trauner M, Fickert P, Wagner M. MDR3 (ABCB4) defects: a paradigm for the genetics of adult cholestatic syndromes. Semin Liver Dis 2007; 27: 77-98
  • 27 Mesenas S, Vu C, Doig L. et al. Duodenal EUS to identify thickening of the extrahepatic biliary tree wall in primary sclerosing cholangitis. Gastrointest Endosc 2006; 63: 403-408
  • 28 Rustemovic N, Cukovic-Cavka S, Opacic M. et al. Endoscopic ultrasound elastography as a method for screening the patients with suspected primary sclerosing cholangitis. Eur J Gastroenterol Hepatol 2010; 22: 748-753
  • 29 Lutz HH, Wasmuth HE, Streetz K. et al. Endoscopic ultrasound as an early diagnostic tool for primary sclerosing cholangitis: a prospective pilot study. Endoscopy 2012; 44: 934-939
  • 30 EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol 2015; 63: 237-264
  • 31 Cotton PB, Nickl N. Endoscopic and radiologic approaches to therapy in primary sclerosing cholangitis. Semin Liver Dis 1991; 11: 40-48
  • 32 Johnson GK, Geenen JE, Venu RP. et al. Endoscopic treatment of biliary tract strictures in sclerosing cholangitis: a larger series and recommendations for treatment. Gastrointest Endosc 1991; 37: 38-43
  • 33 Stiehl A, Rudolph G, Klöters-Plachky P. et al. Development of dominant bile duct stenoses in patients with primary sclerosing cholangitis treated with ursodeoxycholic acid: outcome after endoscopic treatment. J Hepatol 2002; 36: 151-156
  • 34 Bjornsson E, Lindqvist-Ottosson J, Asztely M. et al. Dominant strictures in patients with primary sclerosing cholangitis. Am J Gastroenterol 2004; 99: 502-508
  • 35 Gluck M, Cantone NR, Brandabur JJ. et al. A twenty-year experience with endoscopic therapy for symptomatic primary sclerosing cholangitis. J Clin Gastroenterol 2008; 42: 1032-1039
  • 36 Ponsioen CY, Lam K, van Milligen de Wit AW. et al. Four years experience with short term stenting in primary sclerosing cholangitis. Am J Gastroenterol 1999; 94: 2403-2407
  • 37 Boyd S, Tenca A, Jokelainen K. et al. Screening primary sclerosing cholangitis and biliary dysplasia with endoscopic retrograde cholangiography and brush cytology: risk factors for biliary neoplasia. Endoscopy 2016; 48: 432-439
  • 38 Aljiffry M, Renfrew PD, Walsh MJ. et al. Analytical review of diagnosis and treatment strategies for dominant bile duct strictures in patients with primary sclerosing cholangitis. HPB (Oxford) 2011; 13: 79-90
  • 39 Levy MJ, Baron TH, Clayton AC. et al. Prospective evaluation of advanced molecular markers and imaging techniques in patients with indeterminate bile duct strictures. Am J Gastroenterol 2008; 103: 1263-1273
  • 40 Charatcharoenwitthaya P, Enders FB, Halling KC. et al. Utility of serum tumor markers, imaging, and biliary cytology for detecting cholangiocarcinoma in primary sclerosing cholangitis. Hepatology 2008; 48: 1106-1117
  • 41 Chapman MH, Webster GJ, Bannoo S. et al. Cholangiocarcinoma and dominant strictures in patients with primary sclerosing cholangitis: a 25-year single-centre experience. Eur J Gastroenterol Hepatol 2012; 24: 1051-1058
  • 42 Gotthardt DN, Rudolph G, Kloters-Plachky P. et al. Endoscopic dilation of dominant stenoses in primary sclerosing cholangitis: outcome after long-term treatment. Gastrointest Endosc 2010; 71: 527-534
  • 43 Kaltenthaler E, Vergel YB, Chilcott J. et al. A systematic review and economic evaluation of magnetic resonance cholangiopancreatography compared with diagnostic endoscopic retrograde cholangiopancreatography. Health Technol Assess 2004; 8 iii: 1-89
  • 44 Baluyut AR, Sherman S, Lehman GA. et al. Impact of endoscopic therapy on the survival of patients with primary sclerosing cholangitis. Gastrointest Endosc 2001; 53: 308-312
  • 45 van Milligen de Wit AW, van Bracht J, Rauws EA. et al. Endoscopic stent therapy for dominant extrahepatic bile duct strictures in primary sclerosing cholangitis. Gastrointest Endosc 1996; 44: 293-299
  • 46 Kaya M, Petersen BT, Angulo P. et al. Balloon dilation compared to stenting of dominant strictures in primary sclerosing cholangitis. Am J Gastroenterol 2001; 96: 1059-1066
  • 47 Cotton PB, Garrow DA, Gallagher J. et al. Risk factors for complications after ERCP: a multivariate analysis of 11,497 procedures over 12 years. Gastrointest Endosc 2009; 70: 80-88
  • 48 Johnson GK, Saeian K, Geenen JE. Primary sclerosing cholangitis treated by endoscopic biliary dilation: review and long-term follow-up evaluation. Curr Gastroenterol Rep 2006; 8: 147-155
  • 49 Lee JG, Schutz SM, England RE. et al. Endoscopic therapy of sclerosing cholangitis. Hepatology 1995; 21: 661-667
  • 50 Wagner S, Gebel M, Meier P. et al. Endoscopic management of biliary tract strictures in primary sclerosing cholangitis. Endoscopy 1996; 28: 546-551
  • 51 Ahrendt SA, Pitt HA, Kalloo AN. et al. Primary sclerosing cholangitis: resect, dilate, or transplant?. Ann Surg 1998; 227: 412-423
  • 52 Beuers U, Spengler U, Sackmann M. et al. Deterioration of cholestasis after endoscopic retrograde cholangiography in advanced primary sclerosing cholangitis. J Hepatol 1992; 15: 140-143
  • 53 Dumonceau JM, Tringali A, Blero D. et al. Biliary stenting: indications, choice of stents and results: European Society of Gastrointest Endosc (ESGE) clinical guideline. Endoscopy 2012; 44: 277-292
  • 54 Ismail S, Kylänpää L, Mustonen H. et al. Risk factors for complications of ERCP in primary sclerosing cholangitis. Endoscopy 2012; 44: 1133-1138
  • 55 Navaneethan U, Jegadeesan R, Nayak S. et al. ERCP-related adverse events in patients with primary sclerosing cholangitis. Gastrointest Endosc 2015; 81: 410-419
  • 56 van Milligen de Wit AW, Rauws EA, van Bracht J. et al. Lack of complications following short-term stent therapy for extrahepatic bile duct strictures in primary sclerosing cholangitis. Gastrointest Endosc 1997; 46: 344-347
  • 57 van den Hazel SJ, Wolfhagen EH, van Buuren HR. et al. Prospective risk assessment of endoscopic retrograde cholangiography in patients with primary sclerosing cholangitis. Dutch PSC Study Group. Endoscopy 2000; 32: 779-782
  • 58 Enns R, Eloubeidi MA, Mergener K. et al. Predictors of successful clinical and laboratory outcomes in patients with primary sclerosing cholangitis undergoing endoscopic retrograde cholangiopancreatography. Can J Gastroenterol 2003; 17: 243-248
  • 59 Bangarulingam SY, Gossard AA, Petersen BT. et al. Complications of endoscopic retrograde cholangiopancreatography in primary sclerosing cholangitis. Am J Gastroenterol 2009; 104: 855-860
  • 60 Alkhatib AA, Hilden K, Adler DG. Comorbidities, sphincterotomy, and balloon dilation predict post-ERCP adverse events in PSC patients: operator experience is protective. Dig Dis Sci 2011; 56: 3685-3688
  • 61 von Seth E, Arnelo U, Enochsson L. et al. Primary sclerosing cholangitis increases the risk for pancreatitis after endoscopic retrograde cholangiopancreatography. Liver Int 2015; 35: 254-262
  • 62 Etzel JP, Eng SC, Ko CW. et al. Complications after ERCP in patients with primary sclerosing cholangitis. Gastrointest Endosc 2008; 67: 643-648
  • 63 Andriulli A, Loperfido S, Napolitano G. et al. Incidence rates of post-ERCP complications: a systematic survey of prospective studies. Am J Gastroenterol 2007; 102: 1781-1788
  • 64 Lombard M, Farrant M, Karani J. et al. Improving biliary-enteric drainage in primary sclerosing cholangitis: experience with endoscopic methods. Gut 1991; 32: 1364-1368
  • 65 Stiehl A, Rudolph G, Sauer P. et al. Efficacy of ursodeoxycholic acid treatment and endoscopic dilation of major duct stenoses in primary sclerosing cholangitis. An 8-year prospective study. J Hepatol 1997; 26: 560-566
  • 66 Linder S, Soderlund C. Endoscopic therapy in primary sclerosing cholangitis: outcome of treatment and risk of cancer. Hepatogastroenterology 2001; 48: 387-392
  • 67 Moreno Luna LE, Gores GJ. Advances in the diagnosis of cholangiocarcinoma in patients with primary sclerosing cholangitis. Liver Transpl 2006; 12 (Suppl. 02) S15-19
  • 68 Tse F, Yuan Y, Moayyedi P. et al. Guidewire-assisted cannulation of the common bile duct for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Cochrane Database Syst Rev Dec 2012; DOI: 10.1002/14651858.CD009662.pub2.
  • 69 Dumonceau JM, Andriulli A, Elmunzer BJ. et al. Prophylaxis of post-ERCP pancreatitis: European Society of Gastrointest Endosc (ESGE) Guideline – updated June 2014. Endoscopy 2014; 46: 799-815
  • 70 Shi N, Deng L, Altaf K. et al. Rectal indomethacin for the prevention of post-ERCP pancreatitis: A meta-analysis of randomized controlled trials. Turk J Gastroenterol 2015; 26: 236-240
  • 71 Andrade-Davila VF, Chavez-Tostado M, Davalos-Cobian C. et al. Rectal indomethacin versus placebo to reduce the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography: results of a controlled clinical trial. BMC Gastroenterol 2015; 15: 85
  • 72 Nicolas-Perez D, Castilla-Rodriguez I, Gimeno-Garcia AZ. et al. Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a cost-effectiveness analysis. Pancreas 2015; 44: 204-210
  • 73 Brand M, Bizos D, O’Farrell Jr P. Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography. Cochrane Database Syst Rev 2010; DOI: 10.1002/14651858.CD007345.pub2.
  • 74 Khashab MA, Chithadi KV, Acosta RD. et al. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc 2015; 81: 81-89
  • 75 Negm AA, Schott A, Vonberg RP. et al. Routine bile collection for microbiological analysis during cholangiography and its impact on the management of cholangitis. Gastrointest Endosc 2010; 72: 284-291
  • 76 Razumilava N, Gores GJ, Lindor KD. Cancer surveillance in patients with primary sclerosing cholangitis. Hepatology 2011; 54: 1842-1852
  • 77 Weismüller TJ, Trivedi PJ, Bergquist A. et al. Patient Age, Sex, and Inflammatory Bowel Disease Phenotype Associate With Course of Primary Sclerosing Cholangitis. Gastroenterology 2017; Mar 5. pii: S0016-5085(17)30236-6 DOI: 10.1053/j.gastro.2017.02.038. [Epub ahead of print]
  • 78 Boonstra K, Weersma RK, van Erpecum KJ. et al. Population-based epidemiology, malignancy risk, and outcome of primary sclerosing cholangitis. Hepatology 2013; 58: 2045-2055
  • 79 de Valle MB, Bjornsson E, Lindkvist B. Mortality and cancer risk related to primary sclerosing cholangitis in a Swedish population-based cohort. Liver Int 2012; 32: 441-448
  • 80 Boberg KM, Bergquist A, Mitchell S. et al. Cholangiocarcinoma in primary sclerosing cholangitis: risk factors and clinical presentation. Scand J Gastroenterol 2002; 37: 1205-1211
  • 81 Levy C, Lymp J, Angulo P. et al. The value of serum CA 19-9 in predicting cholangiocarcinomas in patients with primary sclerosing cholangitis. Dig Dis Sci 2005; 50: 1734-1740
  • 82 Sinakos E, Saenger AK, Keach J. et al. Many patients with primary sclerosing cholangitis and increased serum levels of carbohydrate antigen 19-9 do not have cholangiocarcinoma. Clin Gastroenterol Hepatol 2011; 9: 434-439e1
  • 83 Venkatesh PG, Navaneethan U, Shen B. et al. Increased serum levels of carbohydrate antigen 19-9 and outcomes in primary sclerosing cholangitis patients without cholangiocarcinoma. Dig Dis Sci 2013; 58: 850-857
  • 84 Wannhoff A, Hov JR, Folseraas T. et al. FUT2 and FUT3 genotype determines CA19-9 cut-off values for detection of cholangiocarcinoma in patients with primary sclerosing cholangitis. J Hepatol 2013; 59: 1278-1284
  • 85 DeOliveira ML, Cunningham SC, Cameron JL. et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg 2007; 245: 755-762
  • 86 Ponsioen CY, Vrouenraets SM, van Milligen de Wit AW. et al. Value of brush cytology for dominant strictures in primary sclerosing cholangitis. Endoscopy 1999; 31: 305-309
  • 87 Lindberg B, Arnelo U, Bergquist A. et al. Diagnosis of biliary strictures in conjunction with endoscopic retrograde cholangiopancreaticography, with special reference to patients with primary sclerosing cholangitis. Endoscopy 2002; 34: 909-916
  • 88 Siqueira E, Schoen RE, Silverman W. et al. Detecting cholangiocarcinoma in patients with primary sclerosing cholangitis. Gastrointest Endosc 2002; 56: 40-47
  • 89 Lal A, Okonkwo A, Schindler S. et al. Role of biliary brush cytology in primary sclerosing cholangitis. Acta Cytol 2004; 48: 9-12
  • 90 Furmanczyk PS, Grieco VS, Agoff SN. Biliary brush cytology and the detection of cholangiocarcinoma in primary sclerosing cholangitis: evaluation of specific cytomorphologic features and CA19-9 levels. Am J Clin Pathol 2005; 124: 355-360
  • 91 Boberg KM, Jebsen P, Clausen OP. et al. Diagnostic benefit of biliary brush cytology in cholangiocarcinoma in primary sclerosing cholangitis. J Hepatol 2006; 45: 568-574
  • 92 Moff SL, Clark DP, Maitra A. et al. Utility of bile duct brushings for the early detection of cholangiocarcinoma in patients with primary sclerosing cholangitis. J Clin Gastroenterol 2006; 40: 336-341
  • 93 Moreno Luna LE, Kipp B, Halling KC. et al. Advanced cytologic techniques for the detection of malignant pancreatobiliary strictures. Gastroenterology 2006; 131: 1064-1072
  • 94 Halme L, Arola J, Numminen K. et al. M. Biliary dysplasia in patients with primary sclerosing cholangitis: additional value of DNA ploidity. Liver Int 2012; 32: 783-789
  • 95 Trikudanathan G, Navaneethan U, Njei B. et al. Diagnostic yield of bile duct brushings for cholangiocarcinoma in primary sclerosing cholangitis: a systematic review and meta-analysis. Gastrointest Endosc 2014; 79: 783-789
  • 96 Navaneethan U, Njei B, Venkatesh PG. et al. Fluorescence in situ hybridization for diagnosis of cholangiocarcinoma in primary sclerosing cholangitis: a systematic review and meta-analysis. Gastrointest Endosc 2014; 79: 943-950e3
  • 97 Navaneethan U, Njei B, Lourdusamy V. et al. Comparative effectiveness of biliary brush cytology and intraductal biopsy for detection of malignant biliary strictures: a systematic review and meta-analysis. Gastrointest Endosc 2015; 81: 168-176
  • 98 Walker SL, McCormick PA. Diagnosing cholangiocarcinoma in primary sclerosing cholangitis: an “evidence based radiology” review. Abdom Imaging 2008; 33: 14-17
  • 99 Karlsen TH, Vesterhus M, Boberg KM. Review article: controversies in the management of primary biliary cirrhosis and primary sclerosing cholangitis. Aliment Pharmacol Ther 2014; 39: 282-301
  • 100 Nanda A, Brown JM, Berger SH. et al. Triple modality testing by endoscopic retrograde cholangiopancreatography for the diagnosis of cholangiocarcinoma. Therap Adv Gastroenterol 2015; 8: 56-65
  • 101 Fukuda Y, Tsuyuguchi T, Sakai Y. et al. Diagnostic utility of peroral cholangioscopy for various bile-duct lesions. Gastrointest Endosc 2005; 62: 374-382
  • 102 Kawakami H, Kuwatani M, Etoh K. et al. Endoscopic retrograde cholangiography versus peroral cholangioscopy to evaluate intraepithelial tumor spread in biliary cancer. Endoscopy 2009; 41: 959-964
  • 103 Nishikawa T, Tsuyuguchi T, Sakai Y. et al. Comparison of the diagnostic accuracy of peroral video-cholangioscopic visual findings and cholangioscopy-guided forceps biopsy findings for indeterminate biliary lesions: a prospective study. Gastrointest Endosc 2013; 77: 219-226
  • 104 Arnelo U, von Seth E, Bergquist A. Prospective evaluation of the clinical utility of single-operator peroral cholangioscopy in patients with primary sclerosing cholangitis. Endoscopy 2015; 47: 696-702
  • 105 Smith MP, Loe RH. Sclerosing cholangitis; review of recent case reports and associated diseases and four new cases. Am J Surg 1965; 110: 239-246
  • 106 Broome U, Lindberg G, Lofberg R. Primary sclerosing cholangitis in ulcerative colitis – a risk factor for the development of dysplasia and DNA aneuploidy?. Gastroenterology 1992; 102: 1877-1880
  • 107 Broome U, Lofberg R, Lundqvist K. et al. Subclinical time span of inflammatory bowel disease in patients with primary sclerosing cholangitis. Dis Colon Rectum 1995; 38: 1301-1305
  • 108 Broome U, Lofberg R, Veress B. et al. Primary sclerosing cholangitis and ulcerative colitis: evidence for increased neoplastic potential. Hepatology 1995; 22: 1404-1408
  • 109 Soetikno RM, Lin OS, Heidenreich PA. et al. Increased risk of colorectal neoplasia in patients with primary sclerosing cholangitis and ulcerative colitis: a meta-analysis. Gastrointest Endosc 2002; 56: 48-54
  • 110 Broome U, Bergquist A. Primary sclerosing cholangitis, inflammatory bowel disease, and colon cancer. Semin Liver Dis 2006; 26: 31-41
  • 111 Lindor KD, Kowdley KV, Harrison ME. et al. ACG Clinical Guideline: Primary sclerosing cholangitis. Am J Gastroenterol 2015; 110: 646-659 ; quiz 60
  • 112 Annese V, Daperno M, Rutter MD. et al. European evidence based consensus for endoscopy in inflammatory bowel disease. J Crohns Colitis 2013; 7: 982-1018
  • 113 Tsaitas C, Semertzidou A, Sinakos E. Update on inflammatory bowel disease in patients with primary sclerosing cholangitis. World J Hepatol 2014; 6: 178-187
  • 114 Claessen MM, Lutgens MW, van Buuren HR. et al. More right-sided IBD-associated colorectal cancer in patients with primary sclerosing cholangitis. Inflamm Bowel Dis 2009; 15: 1331-1336
  • 115 Vera A, Gunson BK, Ussatoff V. et al. Colorectal cancer in patients with inflammatory bowel disease after liver transplantation for primary sclerosing cholangitis. Transplantation 2003; 75: 1983-1988
  • 116 Jorgensen KK, Grzyb K, Lundin KE. et al. Inflammatory bowel disease in patients with primary sclerosing cholangitis: clinical characterization in liver transplanted and nontransplanted patients. Inflamm Bowel Dis 2012; 18: 536-545
  • 117 Fausa O, Schrumpf E, Elgjo K. Relationship of inflammatory bowel disease and primary sclerosing cholangitis. Semin Liver Dis 1991; 11: 31-39
  • 118 Kaminski MF, Hassan C, Bisschops R. et al. Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2014; 46: 435-449
  • 119 Subramanian V, Mannath J, Ragunath K. et al. Meta-analysis: the diagnostic yield of chromoendoscopy for detecting dysplasia in patients with colonic inflammatory bowel disease. Aliment Pharmacol Ther 2011; 33: 304-312
  • 120 Rutter MD, Saunders BP, Wilkinson KH. et al. Most dysplasia in ulcerative colitis is visible at colonoscopy. Gastrointest Endosc 2004; 60: 334-339
  • 121 Rubin DT, Rothe JA, Hetzel JT. et al. Are dysplasia and colorectal cancer endoscopically visible in patients with ulcerative colitis?. Gastrointest Endosc 2007; 65: 998-1004
  • 122 Riddell RH, Goldman H, Ransohoff DF. et al. Dysplasia in inflammatory bowel disease: standardized classification with provisional clinical applications. Human Pathol 1983; 14: 931-968
  • 123 Connell WR, Lennard-Jones JE, Williams CB. et al. Factors affecting the outcome of endoscopic surveillance for cancer in ulcerative colitis. Gastroenterology 1994; 107: 934-944
  • 124 Ullman TA, Loftus Jr EV, Kakar S. et al. The fate of low grade dysplasia in ulcerative colitis. Am J Gastroenterol 2002; 97: 922-927
  • 125 Befrits R, Ljung T, Jaramillo E. et al. Low-grade dysplasia in extensive, long-standing inflammatory bowel disease: a follow-up study. Dis Colon Rectum 2002; 45: 615-620
  • 126 Lim CH, Dixon MF, Vail A. et al. Ten year follow up of ulcerative colitis patients with and without low grade dysplasia. Gut 2003; 52: 1127-1132