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It introduces the term “relevant stricture” and defines diagnostic criteria, alongside guidance for equivocal MRI/MRCP findings, emphasizing repeat high-quality imaging and avoiding ERCP for PSC diagnosis. The document also provides a structured framework of PSC definitions and related entities, and lists commonly used medical abbreviations for clinical application.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/aasld-practice-guidance-on-primary-sclerosing-cholangitis-and-cholangiocarcinoma-practice-guidance/390314/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/aasld-practice-guidance-on-primary-sclerosing-cholangitis-and-cholangiocarcinoma-practice-guidance/390314.png","ImageObject",300,407,{"name":92,"@type":93},"Well Done","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-25",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What new guidance is included for cholangiocarcinoma in this document?","Question",{"text":113,"@type":114},"The guidance includes diagnostic and management recommendations for cholangiocarcinoma (CCA) in patients with and without primary sclerosing cholangitis (PSC).","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How should equivocal MRI/MRCP findings be handled for diagnosing PSC?",{"text":118,"@type":114},"For equivocal MRI/MRCP findings, a repeated high-quality MRI/MRCP should be performed for diagnostic purposes. ERCP should be avoided for the diagnosis of PSC.",{"name":120,"@type":111,"acceptedAnswer":121},"What is “relevant stricture” in the context of PSC?",{"text":122,"@type":114},"“Relevant stricture” refers to any biliary stricture of the common hepatic duct or associated hepatic ducts accompanied by signs or symptoms of obstructive cholestasis and/or bacterial cholangitis.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},390314,1790647984,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},5909892210082,"https://ap-avatar.wpscdn.com/avatar/56001069da27c9f41e8?x-image-process=image/resize,m_fixed,w_180,h_180&k=1789614185077863061","Received: 26 July 2022 | Accepted: 26 July 2022  \n\n| DOI: 10.1002/hep.32771\u003Cbr>P R A C T I C E G U I DA N C E\u003Cbr>| |\n| --- | --- |\n| AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma\u003Cbr>Christopher L. Bowlus1  | Lionel Arrivé2 | Annika Bergquist3 | Mark Deneau4  | Lisa Forman5 | Sumera I. Ilyas6  | Keri E. Lunsford7 | Mercedes Martinez8  | Gonzalo Sapisochin9 | Rachna Shroff10 | James H. Tabibian11 | David N. Assis12\u003Cbr>1Division of Gastroenterology, University of California Davis Health, Sacramento, California, USA 2Hôpital Saint-Antoine, Paris, France\u003Cbr>3Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden 4University of Utah, Salt Lake City, Utah, USA\u003Cbr>5University of Colorado, Aurora, Colorado, USA\u003Cbr>6Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA 7Rutgers University–New Jersey Medical School, Newark, New Jersey, USA\u003Cbr>8Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA 9University of Toronto, Toronto, Ontario, Canada\u003Cbr>10University of Arizona, Tucson, Arizona, USA\u003Cbr>11David Geffen School of Medicine at UCLA, Los Angeles, California, USA 12Yale School of Medicine, New Haven, Connecticut, USA\u003Cbr>Correspondence\u003Cbr>Christopher L. Bowlus, Division of Gastroenterology, University of California, Davis, 4150 V Street, Suite 3500, Sacramento, CA 95817, USA. Email: [clbowlus@ucdavis.edu](clbowlus@ucdavis.edu) |  |\n| WHAT’S NEW SINCE THE 2010\u003Cbr>GUIDELINES?\u003Cbr>• Inclusion of guidance for the diagnosis and management of cholangiocarcinoma (CCA) in patients with and without primary sclerosing cholangitis (PSC)(Figures 5, 8 , and 9) .\u003Cbr>• Introduction of the term relevant stricture, defined as any biliary stricture of the common hepatic duct or | hepatic ducts associated with signs or symptoms of obstructive cholestasis and/or bacterial cholangitis (Table 1) .\u003Cbr>• In patients with equivocal MRI with cholangiopancreatography (MRI/MRCP) findings, a repeated high-quality MRI/MRCP should be performed for diagnostic purposes. Endoscopic retrograde cholangiopancreatography (ERCP) should be avoided for the diagnosis of PSC (Figure 2) . |\n| Abbreviations: AASLD, American Association for the Study of Liver Diseases; AIH, autoimmune hepatitis; ALP, alkaline phosphatase; ASIR, age standardized incidence rate; AST, aspartate aminotransferase; BRAF, B-raf proto-oncogene; CA 19-9, carbohydrate antigen 19-9; CCA, cholangiocarcinoma; CRC, colorectal cancer; 3D, three-dimensional; dCCA, distal cholangiocarcinoma; debTACE, drug-eluting bead transarterial chemoembolization; ECOG, Eastern Cooperation Oncology Group; ELF, Enhanced Liver Fibrosis; ERCP, endoscopic retrograde cholangiopancreatography; EUS, endoscopic ultrasound; FDA, Food and Drug Administration; FGFR2, FGF receptor 2; FISH, fluorescent in situ hybridization; FNA, fine-needle aspiration; FOLFOX, 5-FU andoxaliplatin; 5-FU, 5-fluorouracil; FUT, fucosyltransferases; gem/cis, gemcitabine/cisplatin; GGT, γ-glutamyl transferase; HGD, high-grade dysplasia; IBD, inflammatory bowel disease; iCCA, intrahepatic cholangiocarcinoma; ICD, International Classification of Diseases; IDH, isocitrate dehydrogenase; LN, lymph node; LRT, locoregional therapy; LS, liver stiffness; LT, liver transplantation; MELD, Model for End-Stage Liver Disease; MRCP, MRI retrograde cholangiopancreatography; MRE, magnetic resonance elastography; OCA, obeticholic acid; ORR, overall response rate; OS, overall survival; PBC, primary biliary cholangitis; pCCA, perihilar cholangiocarcinoma; PET, positron emission tomography; PFS, progression-free survival; PREsTO, PSC Risk Estimate Tool; PSC, primary sclerosing cholangitis; RFS, recurrence-free survival; rPSC, recurrent PSC; SBRT, stereotactic body radiation therapy; SCOPE, Sclerosing Cholangitis Outcomes in Pediatrics; TACE, transarterial chemoembolization; TARE, transarterial radioembolization; TE, transient elastography; T1w/T2w, T1-weighted/T2-weighted; UDCA, ","cbCaiiFkr9Wn6dBa","https://ap.wps.com/l/cbCaiiFkr9Wn6dBa","pdf",5821890,44,"English","# What’s new since the 2010 guidelines?\n# Abbreviations\n# Table 1 Definitions in PSC","[{\"question\":\"What new guidance is included for cholangiocarcinoma in this document?\",\"answer\":\"The guidance includes diagnostic and management recommendations for cholangiocarcinoma (CCA) in patients with and without primary sclerosing cholangitis (PSC).\"},{\"question\":\"How should equivocal MRI/MRCP findings be handled for diagnosing PSC?\",\"answer\":\"For equivocal MRI/MRCP findings, a repeated high-quality MRI/MRCP should be performed for diagnostic purposes. ERCP should be avoided for the diagnosis of PSC.\"},{\"question\":\"What is “relevant stricture” in the context of PSC?\",\"answer\":\"“Relevant stricture” refers to any biliary stricture of the common hepatic duct or associated hepatic ducts accompanied by signs or symptoms of obstructive cholestasis and/or bacterial cholangitis.\"}]","AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma - Practice Guidance | PDF",1790332626,111]