In patients with primary sclerosing cholangitis (PSC), confirmation of cholangiocarcinoma or high-grade biliary dysplasia represents a critical clinical juncture requiring immediate specialist evaluation and coordinated multidisciplinary decision-making.
PSC with confirmed cholangiocarcinoma or high-grade biliary dysplasia. When this diagnosis is established, referral to a specialised centre is recommended to ensure that the full spectrum of management options can be assessed and offered.
Management in this setting is guided by a multidisciplinary approach. Depending on individual patient factors, a palliative treatment pathway — which may include systemic options — is among the frameworks considered. The complete protocol defines the specific criteria, sequencing, and conditions that determine the appropriate path.
DOI: 10.1016/j.jhep.2022.05.011
Referral to a specialised centre is recommended when CCA or high-grade dysplasia is confirmed.
In a multidisciplinary approach, therapeutic options including liver transplantation, liver resection, irradiation, brachy- or systemic therapy or combinations should be considered.
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