{Reference Type}: Practice Guideline
{Title}: Non-invasive diagnosis and follow-up of primary sclerosing cholangitis.
{Author}: Chazouillères O;Potier P;Bouzbib C;Hanslik B;Heurgue A;NGuyen-Khac E;Gournay J;Tanne F;Bureau C;Bourlière M;Ganne-Carrié N;de Lédinghen V;
{Journal}: Clin Res Hepatol Gastroenterol
{Volume}: 46
{Issue}: 1
{Year}: Jul 2021 28
{Factor}: 3.189
{DOI}: 10.1016/j.clinre.2021.101775
{Abstract}: Primary sclerosing cholangitis (PSC) is a rare and chronic cholestatic liver disease of unknown cause commonly associated with inflammatory bowel disease (IBD) and characterized by progressive obliterative fibro-inflammation of the biliary tree. Although the natural course is highly variable, PSC is often progressive, leading to biliary cirrhosis and its complications. In addition, PSC is a condition harbouring broad neoplastic potential with increased susceptibility for the development of both biliary and colon cancer. As in other chronic liver diseases, non-invasive methods play a major role in the diagnosis and monitoring of PSC. MR cholangiography is the key exam for the diagnosis and has replaced diagnostic endoscopic retrograde cholangiopancreatography (ERCP). A strict and standardised protocol for carrying out MR cholangiography is recommended. Liver stiffness measured by FibroScan® correlates with the degree of liver fibrosis, has a prognostic value and should be repeated during follow-up. Invasive methods still play an important role, especially ERCP which is indicated for therapeutic purposes or for endo-biliary sample collection in suspected cholangiocarcinoma (following discussion in a multidisciplinary team meeting) and total colonoscopy which is recommended at the initial diagnosis of any PSC and annually in patients with IBD.