Tests and Procedures

Your hospital will provide you with patient information about the procedure and what to do before and after it. Your hospital’s website should include patient information sheets. If you cannot find the one you want, try looking at the patient information supplied on the websites of other hospitals.

The details included in this section have been written by patients who have undergone these common procedures. How the procedure is conducted may vary slightly between hospitals. When using the internet be aware that some websites are not UK-based and so may offer slight differences in procedure and opinions.

Wiencke and Boberg (2011) set out the following recommendations for follow-up of primary sclerosing cholangitis (PSC) patients:

  • In newly diagnosed PSC patients without known IBD, a full colonoscopy with biopsies is recommended.
  • In PSC patients with IBD, surveillance colonoscopy with biopsies should be carried out every 1-2 years from the time of diagnosis of PSC to exclude colorectal neoplasia. IBD should be treated according to guidelines for IBD.
  • Annual ultrasound is recommended to detect gallbladder mass lesions, and cholecystectomy is recommended in PSC patients with a gallbladder mass lesion of any size.
  • There is currently no evidence-based screening strategy for cholangiocarcinoma in PSC, and no general recommendations for surveillance can be given. ERC with brush cytology (and/or biopsy) is recommended when clinically indicated (deterioration of clinical status and/or biochemical liver tests or recognition of a dominant stricture). In the absence of an evidence-based strategy, many clinicians use imaging modalities (ultrasound, MRI) in combination with CA19-9 at annual intervals.
  • In PSC patients with liver cirrhosis, surveillance for development of hepatocellular carcinoma should follow general recommendations.

Wiencke and Boberg (2011) Current consensus on the management of primary sclerosing cholangitis. Clinics and Research in Hepatology and Gastroenterology 35:786-791

Reviewed 10/05/12

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