Published online Feb 16, 2019. doi: 10.4253/wjge.v11.i2.84
Peer-review started: December 7, 2018
First decision: December 17, 2018
Revised: January 15, 2019
Accepted: January 30, 2019
Article in press: January 30, 2019
Published online: February 16, 2019
Primary sclerosing cholangitis (PSC) is a rare but prominent fibroinflammatory cholangiopathy which can affect individuals of essentially any age. It carries a median survival of 15-20 years, regardless of age at diagnosis, and is a foremost risk factor for cholangiocarcinoma. Given the chronic and progressive nature of PSC, its inherent risk for biliary tract and other complications, and the paucity of effective pharmacotherapies, endoscopy plays a major role in the care of many patients with this disorder. In this review, we discuss the endoscopic management of PSC, including established and evolving approaches to the diagnosis and treatment of its benign as well as malignant sequelae. Owing to the rarity of PSC and dearth of high-quality evidence, we propose pragmatic approaches based on both currently available data and expert opinion.
Core tip: Primary sclerosing cholangitis is a chronic, inflammatory condition of the biliary tract associated with several biliary and extrabiliary complications requiring endoscopic evaluation, treatment, and surveillance.