The Benefit of Endoscopic Stenting for Dominant Strictures in Patients with Primary Sclerosing Cholangitis

Background and study aims: Dominant strictures (DS) occur in up to 60% of patients with primary sclerosing cholangitis (PSC). Data regarding the long-term effects of stenting vs. dilation remain limited. The aim of this study was to compare the 2 treatment modalities in terms of transplantation-free survival. Patients and methods: This single-center, retrospective study examined patients with PSC and DS treated endoscopically with a minimum of 1-year follow-up. Patients were divided into two cohorts: 1) those who received dilation alone, and 2) those who received both dilation and stenting. The primary outcome was transplantation-free survival, defined as time after index ERCP to liver transplantation. Results: In all, 169 patients (54 in dilation cohort, 115 in stenting cohort) were included. The stenting cohort had a significantly higher Mayo PSC risk score (1.8 ± 1.1 vs. 0.9 ± 1.2) and presented with cholangitis more frequently (22.6% vs. 1.9%). During a follow-up period of 1198 person-years, 69 (40.8%) patients received transplantation at a mean of 3.4 (± 2.9) years. There was no difference in transplantation rate in the stenting cohort [68 (95% CI 5.2-8.8) per 100 person-years] compared to the dilation cohort [3.7 (95% CI 2.1-6.0) per 100 person-years] and no difference in risk for transplantation (dilation cohort adjusted hazards ratio 0.67, 95% CI 0.33-1.32). Conclusions: Despite a higher Mayo Risk Score in the stenting group, there was no difference in transplantation-free survival between patients managed with stenting vs. dilation alone. Stenting, therefore, may offer benefit in patients with advanced PSC and DS.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: The Benefit of Endoscopic Stenting for Dominant Strictures in Patients with Primary Sclerosing Cholangitis ; day:09 ; month:06 ; year:2022 ; Endoscopy International Open ; (09.06.2022)

Contributors, Places and Time

• Contributor: Han, Samuel ; Shah, Raj J.

Further information

• DOI: 10.1055/a-1873-0961
• URN: urn:nbn:de:101:1-2022072809092879393013
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:36 AM CEST