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World J Gastrointest Endosc. 2019 Feb 16;11(2):84-94. doi: 10.4253/wjge.v11.i2.84.

Role of endoscopy in the management of primary sclerosing cholangitis.

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Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA Gastroenterology Fellowship Training Program, Los Angeles, CA 90095, United States.
Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States.


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.


Bile duct diseases; Biopsy; Cholangiocarcinoma; Endoscopic retrograde cholangiopancreatography; Inflammatory bowel disease; Primary sclerosing cholangitis

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Conflict-of-interest statement: The authors have no financial disclosures or conflicts of interest.

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