Treatment-Primary sclerosing cholangitis (PSC)

• supportive care, fat-soluble vitamins; no meds have improved survival
• UDCA may ↓ Aϕ & improve Sx, but unclear if beneficial
• If dominant stricture → endoscopic dilation, stenting or surgical resection can help
• Cholangiocarcinoma:
  • 15% lifetime risk;
  • annual surveillance w/ MRCP or U/S & CA19-9
• Liver transplantation:
  • ~30% recurrence,
  • though if UC,
  • colectomy may ↓ recurrence