Review article: current management of primary sclerosing cholangitis.
The management of primary sclerosing cholangitis (PSC) is hindered by incomplete understanding of the pathogenesis of the disease and the lack of good prognostic models. Few large randomized controlled trials of drug therapy have been published. Best practice in the management of PSC is currently based therefore on careful interpretation of the available evidence, close observation of individual patients and clinical experience of the disease. Drug therapy is useful for alleviating symptoms. Ursodeoxycholic acid may slow progression of the disease and reduce the frequency of complications. Consensus is emerging on the issues of screening for the malignant complications of PSC and the indications for liver transplantation are becoming broader and encompassing the earliest stages of cholangiocarcinoma. In view of the rarity of the disease in the general population, large international collaborations to study PSC are necessary to provide clearer answers in areas of uncertainty, and these are now beginning to emerge.
Cullen
S N
SN
John Radcliffe Hospital, Oxford OX3 9DU, UK. suecullen101@hotmail.com
Chapman
R W
RW
D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D015209:Cholangitis, Sclerosing / Q000175:diagnosis / Q000532:radiotherapy / Q000628:therapy*; D002779:Cholestasis / Q000209:etiology; D003131:Combined Modality Therapy / Q000379:methods; D016145:Endoscopy, Digestive System / Q000379:methods; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000150:complications; D008103:Liver Cirrhosis / Q000150:complications; D017093:Liver Failure / Q000209:etiology; D016031:Liver Transplantation / Q000379:methods; D015607:Stents; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D002756:Cholagogues and Choleretics; D007166:Immunosuppressive Agents; D014580:Ursodeoxycholic Acid