Background
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by progressive inflammation and fibrosis of the bile ducts. It is strongly associated with inflammatory bowel disease (IBD), particularly ulcerative colitis, which predisposes affected patients to an increased risk of colorectal dysplasia and carcinoma. Managing these patients poses substantial clinical challenges, especially when both liver transplantation (LT) for end-stage liver disease due to PSC and total abdominal colectomy (TAC) for dysplasia or malignancy are indicated. Current literature guiding clinical decisions around the sequence and outcomes of these interventions remains limited. This gap underscores the need for robust data to inform surgical timing, cancer prognosis, and post-operative complication risks, including outcomes related to ileal pouch-anal anastomosis (IPAA).
