ArticleGut2019
Effect of scheduled endoscopic dilatation of dominant strictures on outcome in patients with primary sclerosing cholangitis.
Article in Gut, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- [Guidelines on the diagnosis and management of primary sclerosing cholangitis (2021)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Guideline
- ERCP-Related Adverse Events in Primary Sclerosing Cholangitis: A Systematic Review and Meta-Analysis.Canadian journal of gastroenterology & hepatology · 2022Pooled it
- Efficacy and Safety of Temporary Fully Covered Self-Expandable Metal Stents for High-Grade Biliary Strictures in Primary Sclerosing Cholangitis: A Single-Center Retrospective Case Series.Digestive diseases and sciences · 2026Article
- Understanding hepatopancreatobiliary cancer risks in a population-based primary sclerosing cholangitis-inflammatory bowel disease cohort.Hepatology (Baltimore, Md.) · 2026Article
- Endoscopic retrograde cholangiopancreatography and primary sclerosing cholangitis: a retrospective study of a high-volume program.Journal of the Canadian Association of Gastroenterology · 2025Article
- Contribution of Endoscopy in the Diagnosis and Treatment of Patients With Primary Sclerosing Cholangitis.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2025Article
- Endoscopic management of primary sclerosing cholangitis.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2025Review
- Statin Use Is Associated With Protection Against Acute Cholangitis in Patients With Primary Sclerosing Cholangitis: A Multicenter Retrospective Cohort Study.Clinical and translational gastroenterology · 2025Article
- Primary sclerosing cholangitis.Nature reviews. Disease primers · 2025Review
- Disease severity prognostication in primary sclerosing cholangitis: a validation of the Anali scores and comparison with the potential functional stricture.European radiology · 2024Article
- Surrogate markers of bile duct disease progression in primary sclerosing cholangitis - A prospective study with repeated ERCP examinations.JHEP reports : innovation in hepatology · 2024Article
- Long-term impact of scheduled regular endoscopic interventions for patients with primary sclerosing cholangitis.Hepatology communications · 2024Article
- Update on the optimisation of endoscopic retrograde cholangiography (ERC) in patients with primary sclerosing cholangitis.Frontline gastroenterology · 2024Article
- Diagnosis of functional strictures in patients with primary sclerosing cholangitis using hepatobiliary contrast-enhanced MRI: a proof-of-concept study.European radiology · 2023Article
- Elevated Liver Fibrosis Progression in Isolated PSC Patients and Increased Malignancy Risk in a PSC-IBD Cohort: A Retrospective Study.International journal of molecular sciences · 2023Article
- Primary Sclerosing Cholangitis-Associated Cholangiocarcinoma: From Pathogenesis to Diagnostic and Surveillance Strategies.Cancers · 2023Review
- Article
- Surveillance for cholangiocarcinoma in patients with primary sclerosing cholangitis: Can we be more proactive?Frontline gastroenterology · 2023Article
- Impact on follow-up strategies in patients with primary sclerosing cholangitis.Liver international : official journal of the International Association for the Study of the Liver · 2023Article
- Benefit of endoscopic stenting for dominant strictures in patients with primary sclerosing cholangitis.Endoscopy international open · 2022Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveScheduled endoscopic dilatation of dominant strictures (DS) in primary sclerosing cholangitis (PSC) might improve outcome relative to endoscopic treatment on demand, but evidence is limited. Since randomisation is difficult in clinical practice, we present a large retrospective study comparing scheduled versus on-demand endoscopic retrograde cholangiopancreatography (ERCP) based on patient preferences.
designBetween 1987 and 2017, all new patients with PSC had been offered scheduled ERCP with dilatation of a DS if diagnosed; the latter was repeated at defined intervals until morphological resolution, independent of clinical symptoms (treatment group). Patients who refused participation were clinically evaluated annually and received endoscopic treatment only on demand (control group). The primary clinical endpoint was transplantation-free survival. Secondary outcomes were overall survival, bacterial cholangitis episodes, hepatic decompensation of liver cirrhosis and endoscopy-related adverse events.
resultsThe final study included 286 patients, 133 (46.5%) receiving scheduled ERCP and 153 (53.5%) receiving on-demand ERCP. After a mean follow-up of 9.9 years, the rate of transplantation-free survival was higher in patients receiving scheduled ERCP (51% vs 29.3%; p<0.001), as was transplantation-free survival time (median: 17.9 vs 15.2 years; log-rank: p=0.008). However, the benefit of scheduled ERCP was significant only in patients with the initial (17.1%) or later (45.5%) diagnosis of a DS (17.8 vs 11.1 years; log-rank: p<0.001). IBD (p=0.03), DS (p=0.006), higher Mayo Risk Score (p=0.02) and non-adherence to scheduled endoscopy (p=0.005) were independently associated with transplantation-free survival.
conclusionIn our large retrospective study, regular ERCP with endoscopic balloon dilatation significantly benefits patients with PSC with DS, diagnosed both at initial presentation and during surveillance, even if asymptomatic. Further studies have to find out how to best identify stricture patients non-invasively.
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