Primary Sclerosing Cholangitis and Cholangiocarcinoma

AASLD develops evidence-based practice guidelines and practice guidances which are updated regularly by a multi-disciplinary panel of experts, including hepatologists, and include recommendations of preferred approaches to the diagnostic, therapeutic, and preventive aspects of care. 

Practice Guidance

Primary sclerosing cholangitis (PSC) is a cholangiopathy characterized by chronic fibroinflammatory damage of the biliary tree and is frequently associated with inflammatory bowel disease  (IBD).  The majority of patients with  PSC  have fibrotic biliary strictures on cholangiogram,  whereas  a minority have small-duct  PSC,  characterized by a normal cholangiogram but with histological features of PSC on liver biopsy.  A  small percentage have overlapping features of autoimmune hepatitis  (PSC-AIH).  PSC affects both male and female individuals and can occur at any age. PSC is considered an autoimmune disease though the pathophysiology remains poorly understood.  PSC frequently results in cholestatic liver damage, cirrhosis, and liver failure and can recur in  20%–30% of patients after transplantation.  PSC also significantly increases the risk of cholangiocarcinoma  (CCA) and colorectal cancer (CRC).

AASLD Practice Guidance on Primary Sclerosing Cholangitis and Cholangiocarcinoma [September 2022]

Supplemental Materials

In response to outreach from the patient community, AASLD drafted an open letter explaining its approach and methodology for the PSC Guidance development. 

AASLD PSC Guidance Support Statement

PSC Partners also released a statement in response to AASLD's PSC Guidance regarding the use of Oral Vancomycin:

PSC Partners Statement 

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