Prognostic value of cholangiography in primary sclerosing cholangitis.
OBJECTIVE
To examine whether bile duct changes observed on the first diagnostic cholangiograms in patients with primary sclerosing cholangitis (PSC) can predict survival without liver transplantation and survival without symptoms of PSC.


METHODS
Retrospective study. Findings from the first diagnostic cholangiograms were correlated with the time until the appearance of PSC symptoms and death.


METHODS
Primary and tertiary clinical care hospital.


METHODS
Ninety-four patients with a diagnosis of PSC based on cholangiography.


METHODS
Time to death or liver transplantation and the first appearance of jaundice, upper abdominal pain, pruritus or fever.


RESULTS
Death or liver transplantation, as well as the occurrence of jaundice, were predicted by the grade of intrahepatic duct obstruction; whereas fever, pruritus and abdominal pain were predicted by the grade of extrahepatic duct obstruction.


CONCLUSIONS
High-grade intrahepatic strictures indicate early jaundice and short survival in patients with PSC. High-grade extrahepatic strictures indicate early pruritus, abdominal pain and fever of presumably PSC origin. The grade of intrahepatic strictures should be incorporated into survival models of PSC.
Olsson
R G
RG
Department of Internal Medicine and Diagnostic Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Asztély
M S
MS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002758:Cholangiography; D015209:Cholangitis, Sclerosing / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate