title: Controversies in the management of primary sclerosing cholangitis.
abstract: Primary sclerosing cholangitis (PSC) remains a rare but significant disease, which affects mainly young males in association with inflammatory bowel disease. There have been few advances in the understanding of the pathogenesis of the condition and no therapeutics with proven mortality benefit aside from liver transplantation. There remain areas of controversy in the management of PSC which include the differentiation from other cholangiopathies, in particular immunoglobulin G4 related sclerosing cholangitis, the management of dominant biliary strictures, and the role of ursodeoxycholic acid. In addition, the timing of liver transplantation in PSC remains difficult to predict with standard liver severity scores. In this review, we address these controversies and highlight the latest evidence base in the management of PSC.
authors.affiliation: Jeremy S Nayagam, John Devlin, Phillip M Harrison, Deepak Joshi, Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom.
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Nayagam
authors.affiliation: Jeremy S Nayagam, John Devlin, Phillip M Harrison, Deepak Joshi, Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Pereira
authors.affiliation: Jeremy S Nayagam, John Devlin, Phillip M Harrison, Deepak Joshi, Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Devlin
authors.affiliation: Jeremy S Nayagam, John Devlin, Phillip M Harrison, Deepak Joshi, Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom.
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Harrison
authors.affiliation: Jeremy S Nayagam, John Devlin, Phillip M Harrison, Deepak Joshi, Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom.
authors.forename: Deepak
authors.initials: D
authors.lastname: Joshi
keywords: Cholangiocarcinoma; Dominant strictures; Immunoglobulin G4 related sclerosing cholangitis; Liver transplantation; Primary sclerosing cholangitis