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Guideline

Role of endoscopy in primary sclerosing cholangitis (EGSE & EASL)

Primary sclerosing cholangitis(PSC) is a chronic bile duct disease with an estimated prevalence in the range of 1–16 per 100,000 with significant regional differences across Europe. The prevalence of PSC is increased in patients with ulcerative colitis and estimated to be in the range 1%–5% [1]. 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 [2]. PSC is more common in men (comprising 60%–70% of patients) and most patients present with pancolitis, often with a rightsided predominance [3–5]. A major challenge in the clinical management of patients is a highly increased and unpredictable risk of biliary and colonic malignancies.

The aim of this evidence- and consensus-based guideline, commissioned by the European Society of Gastrointestinal Endoscopy (ESGE) and the EASL, is to provide practical advice on how to utilize ERCP and colonoscopy in PSC patients, in order to maximize their benefit and minimize their burden and adverse events.

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