Surveillance and screening of primary sclerosing cholangitis

Primary sclerosing cholangitis (PSC) represents an idiopathic chronic cholestatic liver disease due to inflammatory destruction of the biliary tree. Clinically, the progressive disease leads to biliary cirrhosis in association with cholangiocarcinoma in 6-20% of the patients. Currently, liver transplantation remains the only life-extending treatment option in end-stage disease. However, due to the high risk of carcinoma development, PSC patients should be tightly screened and evaluated including newer technologies like endoscopic ultrasound-guided fine-needle aspiration biopsy and cholangioscopy including cytology and direct biopsy of the biliary mucosal lesions.