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2017 | Topic: Immune mediated and cholestatic diseases

Role of Endoscopy in Primary Sclerosing Cholangitis

This guideline on Role of Endoscopy in Primary Sclerosing Cholangitis is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE) and of the European Association for the Study of the Liver (EASL) on primary sclerosing cholangitis. In order to define the strength of recommendations and the quality of evidence  we have adopted The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

More on the Role of Endoscopy in Primary Sclerosing Cholangitis

Primary sclerosing cholangitis(PSC) is a chronic bile duct disease. It has an estimated prevalence in the range of 1–16 per 100,000 with significant regional  differences across Europe. Patients with ulcerative colitis have an increased prelevance of PSC and estimated to be in the range 1%–5%. Magnetic resonance
imaging (MRI) studies have shown that the prevalence of imaging changes compatible with PSC in ulcerative colitis is almost fourfold higher than that detected based on clinical assessments. PSC is more common in men (comprising 60%–70% of patients) and most patients present with pancolitis. Often with a rightsided predominance. A major challenge in the clinical management of patients is a highly increased and unpredictable risk of biliary and colonic malignancies.

The diagnosis of Primary Sclerosing Cholangitis

A combination of different factors sits at the base of a PSC Diagnosis. Among them disease (IBD) and abnormal liver biochemistry test findings, especially elevated alkaline phosphatase (ALP) and gamma glutamyl transferase (GGT) values. As well as in nonIBD patients with elevated cholestatic liver enzymes not otherwise explained. Finally, a proposed algorithm for PSC diagnosis has already been presented by earlier EASL guidelines. Therefore, the present guideline will not address comprehensive discussion of issues unrelated to the use of endoscopy in PSC.

Download the EASL Guideline Role of Endoscopy in Primary Sclerosing Cholangitis as PDF or PPT Slide Deck.

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