Primary sclerosing cholangitis: prognosis
Last reviewed: 23.04.2024
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In one study, the life expectancy at primary sclerosing cholangitis from the moment of diagnosis was 11.9 years on average. In another study, 9 years after the diagnosis, 75% of the patients remained alive.
When monitoring patients with asymptomatic course of the disease for 6 years, its progression was revealed in 70% of them in a third with the development of liver failure.
Although some patients may feel satisfactory, the majority of people develop cholestatic jaundice and liver damage, most vividly manifested by bleeding from esophageal varices, hepatic insufficiency and cholangiocarcinoma.
The prognosis for lesion of extrahepatic bile ducts is worse than with lesion only intrahepatic.
After proktokoloktomii bleeding from varicose-dilated veins located around the colostomy can develop.
With nonspecific ulcerative colitis, the presence of pericholangitis and sclerosing cholangitis increases the risk of dysplasia and colorectal cancer.
To facilitate assessment of the results of treatment, distribution of patients in groups during clinical trials and to determine the optimal timing for liver transplantation, survival models have been developed. In the Mayo Clinic model, based on the material of 5 medical centers, in which 426 patients were observed, the serum bilirubin concentration, the histological stage, the age of the patients and the presence of splenomegaly are taken into account. The predicted survival after diagnosis was 78%. The survival rate of women was lower than that of men. The significance of models for individual patients is small, since the disease varies in different patients. In addition, the models do not allow to identify patients with cholangiocarcinoma.
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