Despite the close relationship between primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD), the association between colectomy and the prognosis of PSC remains controversial.
Dr Nordenvall and colleagues from Sweden explored whether colectomy prior to PSC-diagnosis is associated with transplant-free survival.
A nationwide cohort study in Sweden including all patients aged 18 to 69 years in whom both PSC and IBD was diagnosed between 1987 and 2014 was undertaken.
The team followed each patient from date of both PSC and IBD diagnoses until liver transplantation or death, or 2014.
|Liver transplantations were performed in 327 patients|
|Alimentary Pharmacology & Therapeutics|
Patients with colon in situ, and colectomy prior to PSC-diagnosis were compared.
Of the 2594 PSC-IBD patients, 205 patients were treated with colectomy before PSC-diagnosis.
During follow-up, the researchers observed that liver transplantations were performed in 327 patients and 509 died.
The team noted that the risk of liver transplantation or death was lower in patients treated with colectomy prior to PSC-diagnosis than in patients with colon in situ.
Male gender, longer time between IBD and PSC-diagnosis and older age were all associated with an increased risk of liver transplantation or death.
The research team found that colectomy after PSC-diagnosis was however not associated with an increased risk of liver transplantation or death during long-term follow-up.
Dr Nordenvall's team comments, "In PSC-IBD patients, colectomy prior to PSC-diagnosis is associated with a decreased risk of liver transplantation or death."