Primary sclerosing cholangitis: surgical options, prognostic variables and outcome
1992

Primary Sclerosing Cholangitis: Surgery or Transplant?

Sample size: 48 publication Evidence: moderate

Author Information

Author(s): Ismail, T., Angrisani, L., Powell, J.E., Hubscher, S., Buckels, J., Neuberger, J., Elias, E., McMaster, P.

Primary Institution: Department of Surgery, Medical School Observatory

Hypothesis

What are the surgical options and outcomes for patients with primary sclerosing cholangitis?

Conclusion

Liver transplantation is the preferred treatment for progressive liver disease in patients with primary sclerosing cholangitis.

Supporting Evidence

  • Twenty-one patients (44 percent) died; overall 5 year actuarial survival was 30 percent.
  • Previous biliary surgery correlated with a poor outcome after liver transplantation.
  • Seventeen patients underwent orthotopic liver transplantation of whom nine are currently alive.

Takeaway

This study looked at patients with a liver disease called primary sclerosing cholangitis and found that surgery doesn't help much, so getting a liver transplant is usually the best choice.

Methodology

Retrospective review of 48 symptomatic patients with primary sclerosing cholangitis.

Potential Biases

Selection bias may affect the outcomes due to the nature of the patient selection.

Limitations

The study is limited by its retrospective nature and the small sample size.

Participant Demographics

Median age 39 years, range 8-67 years; 30 male; 30 patients had inflammatory bowel disease.

Statistical Information

P-Value

p<0.0001

Statistical Significance

p<0.0001

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