{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:44:29Z","timestamp":1786977869739,"version":"build-2736575974"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2018,5,4]],"date-time":"2018-05-04T00:00:00Z","timestamp":1525392000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatology Communications"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:p>\n                    Dominant strictures (DSs) of the biliary tree occur in approximately 50% of patients with primary sclerosing cholangitis (PSC) and may cause significant morbidity. Nevertheless, the definition and management of DSs lacks consensus. We aimed to better understand current perceptions and practices regarding PSC\u2010associated DSs. We conducted an anonymous, 23\u2010question, survey\u2010based study wherein electronic surveys were distributed to 131 faculty in the Division of Gastroenterology and Hepatology at the three Mayo Clinic campuses (Rochester, Scottsdale, and Jacksonville) as well as the affiliated practice network. Responses were aggregated and compared, where applicable, to practice guidelines of the American Association for the Study of Liver Diseases and European Association for the Study of the Liver. A total of 54 faculty (41.2%) completed the survey, of whom 24 (44.4%) were hepatologists, 21 (38.9%) gastroenterologists, and 9 (16.7%) advanced endoscopists. One of the major study findings was that there was heterogeneity among participants' definition, evaluation, management, and follow\u2010up of DSs in PSC. The majority of participant responses were in accordance with societal practice guidelines, although considerable variation was noted.\n                    <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                    Despite the prevalence and morbidity of DSs in PSC, clinical perceptions and practices vary widely among hepatologists, gastroenterologists, and advanced endoscopists who manage these patients, even within a single health care system. Further studies are needed to address these variations, develop general and evidence\u2010based consensus, and increase adherence to societal guidelines. (\n                    <jats:italic toggle=\"yes\">Hepatology Communications<\/jats:italic>\n                    2018;2:836\u2010844)\n                  <\/jats:p>","DOI":"10.1002\/hep4.1194","type":"journal-article","created":{"date-parts":[[2018,5,4]],"date-time":"2018-05-04T11:38:56Z","timestamp":1525433936000},"page":"836-844","source":"Crossref","is-referenced-by-count":37,"title":["Dominant strictures in primary sclerosing cholangitis: A multicenter survey of clinical definitions and practices"],"prefix":"10.1097","volume":"2","author":[{"given":"Moira B.","family":"Hilscher","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Mayo Clinic,Rochester,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9104-1702","authenticated-orcid":false,"given":"James H.","family":"Tabibian","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Mayo Clinic,Rochester,MN"},{"name":"Division of Gastroenterology,Olive View\u2010University of California Los Angeles Medical Center,Sylmar,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth J.","family":"Carey","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Mayo Clinic,Scottsdale,AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Gostout","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Mayo Clinic,Rochester,MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith D.","family":"Lindor","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Mayo Clinic,Scottsdale,AZ"},{"name":"College of Health Solutions,Arizona State University,Phoenix,AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,5,4]]},"reference":[{"key":"hep41194-bib-0001-20240114","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/0016-5085(80)90131-6","article-title":"Clinicopathologic features of the syndrome of primary sclerosing cholangitis","volume":"79","year":"1980","journal-title":"Gastroenterology"},{"key":"hep41194-bib-0002-20240114","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1136\/gut.21.10.870","article-title":"Primary sclerosing cholangitis: a review of its clinical features, cholangiography, and hepatic histology","volume":"21","year":"1980","journal-title":"Gut"},{"key":"hep41194-bib-0003-20240114","doi-asserted-by":"crossref","first-page":"655","DOI":"10.3109\/00365528709011139","article-title":"Primary sclerosing cholangitis: a long\u2010term follow\u2010up study","volume":"22","year":"1987","journal-title":"Scand J Gastroenterol"},{"key":"hep41194-bib-0004-20240114","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1002\/hep.26565","article-title":"Population\u2010based epidemiology, malignancy risk, and outcome of primary sclerosing cholangitis","volume":"58","year":"2013","journal-title":"Hepatology"},{"key":"hep41194-bib-0005-20240114","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1572-0241.2006.00872.x","article-title":"Characterization, outcome, and prognosis in 273 patients with primary sclerosing cholangitis: a single center study","volume":"102","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"hep41194-bib-0006-20240114","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1053\/j.gastro.2008.01.042","article-title":"The natural history of small\u2010duct primary sclerosing cholangitis","volume":"134","year":"2008","journal-title":"Gastroenterology"},{"key":"hep41194-bib-0007-20240114","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1002\/hep.1840100406","article-title":"Primary sclerosing cholangitis: natural history, prognostic factors and survival analysis","volume":"10","year":"1989","journal-title":"Hepatology"},{"key":"hep41194-bib-0008-20240114","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/MOG.0000000000000333","article-title":"The evolution of natural history of primary sclerosing cholangitis","volume":"33","year":"2017","journal-title":"Curr Opin Gastroenterol"},{"key":"hep41194-bib-0009-20240114","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.2214\/ajr.145.5.1061","article-title":"Nonoperative dilatation of dominant strictures in primary sclerosing cholangitis","volume":"145","year":"1985","journal-title":"AJR Am J Roentgenol"},{"key":"hep41194-bib-0010-20240114","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1111\/j.1572-0241.2004.04106.x","article-title":"Dominant strictures in patients with primary sclerosing cholangitis","volume":"99","year":"2004","journal-title":"Am J Gastroenterol"},{"key":"hep41194-bib-0011-20240114","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/S0168-8278(01)00251-3","article-title":"Development of dominant bile duct stenoses in patients with primary sclerosing cholangitis treated with ursodeoxycholic acid: outcome after endoscopic treatment","volume":"36","year":"2002","journal-title":"J Hepatol"},{"key":"hep41194-bib-0012-20240114","first-page":"685","article-title":"Primary sclerosing cholangitis: clinical presentation, natural history and prognostic variables: an Italian multicentre study. The Italian PSC Study Group","volume":"8","year":"1996","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"hep41194-bib-0013-20240114","doi-asserted-by":"crossref","first-page":"959","DOI":"10.2214\/ajr.157.5.1927817","article-title":"Primary sclerosing cholangitis: value of cholangiography in determining the prognosis","volume":"157","year":"1991","journal-title":"AJR Am J Roentgenol"},{"key":"hep41194-bib-0014-20240114","first-page":"251","article-title":"Prognostic value of cholangiography in primary sclerosing cholangitis","volume":"7","year":"1995","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"hep41194-bib-0015-20240114","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/j.jhep.2017.02.013","article-title":"Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline","volume":"66","year":"2017","journal-title":"J Hepatol"},{"key":"hep41194-bib-0016-20240114","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.cld.2010.03.010","article-title":"Endoscopic retrograde cholangiopancreatography in diagnosis and treatment of primary sclerosing cholangitis","volume":"14","year":"2010","journal-title":"Clin Liver Dis"},{"key":"hep41194-bib-0017-20240114","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/S0016-5107(97)70123-8","article-title":"Lack of complications following short\u2010term stent therapy for extrahepatic bile duct strictures in primary sclerosing cholangitis","volume":"46","year":"1997","journal-title":"Gastrointest Endosc"},{"key":"hep41194-bib-0018-20240114","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/S0016-5107(01)70403-8","article-title":"Impact of endoscopic therapy on the survival of patients with primary sclerosing cholangitis","volume":"53","year":"2001","journal-title":"Gastrointest Endosc"},{"key":"hep41194-bib-0019-20240114","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1055\/s-2008-1040421","article-title":"Endoscopic and radiologic approaches to therapy in primary sclerosing cholangitis","volume":"11","year":"1991","journal-title":"Semin Liver Dis"},{"key":"hep41194-bib-0020-20240114","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/S0016-5107(91)70618-4","article-title":"Endoscopic treatment of biliary tract strictures in sclerosing cholangitis: a larger series and recommendations for treatment","volume":"37","year":"1991","journal-title":"Gastrointest Endosc"},{"key":"hep41194-bib-0021-20240114","first-page":"2000","article-title":"Endoscopic management of primary sclerosing cholangitis: review, and report of an open series","volume":"88","year":"1993","journal-title":"Am J Gastroenterol"},{"key":"hep41194-bib-0022-20240114","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1097\/00000658-199803000-00014","article-title":"Primary sclerosing cholangitis: resect, dilate, or transplant?","volume":"227","year":"1998","journal-title":"Ann Surg"},{"key":"hep41194-bib-0023-20240114","doi-asserted-by":"crossref","first-page":"2403","DOI":"10.1111\/j.1572-0241.1999.01364.x","article-title":"Four years experience with short term stenting in primary sclerosing cholangitis","volume":"94","year":"1999","journal-title":"Am J Gastroenterol"},{"key":"hep41194-bib-0024-20240114","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0016-5107(96)70167-0","article-title":"Endoscopic stent therapy for dominant extrahepatic bile duct strictures in primary sclerosing cholangitis","volume":"44","year":"1996","journal-title":"Gastrointest Endosc"},{"key":"hep41194-bib-0025-20240114","first-page":"661","article-title":"Endoscopic therapy of sclerosing cholangitis","volume":"21","year":"1995","journal-title":"Hepatology"},{"key":"hep41194-bib-0026-20240114","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.4253\/wjge.v7.i11.1003","article-title":"Endoscopic management of benign biliary strictures","volume":"7","year":"2015","journal-title":"World J Gastrointest Endosc"},{"key":"hep41194-bib-0027-20240114","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1016\/S0168-8278(97)80421-7","article-title":"Efficacy of ursodeoxycholic acid treatment and endoscopic dilation of major duct stenoses in primary sclerosing cholangitis. An 8\u2010year prospective study","volume":"26","year":"1997","journal-title":"J Hepatol"},{"key":"hep41194-bib-0028-20240114","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1002\/hep.23294","article-title":"Diagnosis and management of primary sclerosing cholangitis","volume":"51","year":"2010","journal-title":"Hepatology"},{"key":"hep41194-bib-0029-20240114","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1097\/MCG.0b013e3181646713","article-title":"A twenty\u2010year experience with endoscopic therapy for symptomatic primary sclerosing cholangitis","volume":"42","year":"2008","journal-title":"J Clin Gastroenterol"},{"key":"hep41194-bib-0030-20240114","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jhep.2009.04.009","article-title":"EASL Clinical Practice Guidelines: management of cholestatic liver diseases","volume":"51","year":"2009","journal-title":"J Hepatol"},{"key":"hep41194-bib-0031-20240114","article-title":"Surveillance for hepatobiliary cancers in patients with primary sclerosing cholangitis","year":"2017","journal-title":"Hepatology"},{"key":"hep41194-bib-0032-20240114","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1111\/j.1572-0241.2004.04067.x","article-title":"Incidence and risk factors for cholangiocarcinoma in primary sclerosing cholangitis","volume":"99","year":"2004","journal-title":"Am J Gastroenterol"},{"key":"hep41194-bib-0033-20240114","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.jhep.2008.08.013","article-title":"High lifetime risk of cancer in primary sclerosing cholangitis","volume":"50","year":"2009","journal-title":"J Hepatol"},{"key":"hep41194-bib-0034-20240114","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1080\/00365521.2016.1263681","article-title":"Clinical implications of serial versus isolated biliary fluorescence in situ hybridization (FISH) polysomy in primary sclerosing cholangitis","volume":"52","year":"2017","journal-title":"Scand J Gastroenterol"},{"key":"hep41194-bib-0035-20240114","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1002\/hep.22441","article-title":"Utility of serum tumor markers, imaging, and biliary cytology for detecting cholangiocarcinoma in primary sclerosing cholangitis","volume":"48","year":"2008","journal-title":"Hepatology"},{"key":"hep41194-bib-0036-20240114","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1002\/hep.1840160315","article-title":"Ursodeoxycholic acid for treatment of primary sclerosing cholangitis: a placebo\u2010controlled trial","volume":"16","year":"1992","journal-title":"Hepatology"},{"key":"hep41194-bib-0037-20240114","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1067\/mge.2002.125105","article-title":"Detecting cholangiocarcinoma in patients with primary sclerosing cholangitis","volume":"56","year":"2002","journal-title":"Gastrointest Endosc"},{"key":"hep41194-bib-0038-20240114","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1053\/j.gastro.2006.08.021","article-title":"Advanced cytologic techniques for the detection of malignant pancreatobiliary strictures","volume":"131","year":"2006","journal-title":"Gastroenterology"},{"key":"hep41194-bib-0039-20240114","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.jhep.2006.05.010","article-title":"Diagnostic benefit of biliary brush cytology in cholangiocarcinoma in primary sclerosing cholangitis","volume":"45","year":"2006","journal-title":"J Hepatol"},{"key":"hep41194-bib-0040-20240114","doi-asserted-by":"crossref","first-page":"1734","DOI":"10.1007\/s10620-005-2927-8","article-title":"The value of serum CA 19\u20109 in predicting cholangiocarcinomas in patients with primary sclerosing cholangitis","volume":"50","year":"2005","journal-title":"Dig Dis Sci"},{"key":"hep41194-bib-0041-20240114","first-page":"350","article-title":"The clinical utility of the CA 19\u20109 tumor\u2010associated antigen","volume":"85","year":"1990","journal-title":"Am J Gastroenterol"},{"key":"hep41194-bib-0042-20240114","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1038\/ajg.2014.433","article-title":"Biliary multifocal chromosomal polysomy and cholangiocarcinoma in primary sclerosing cholangitis","volume":"110","year":"2015","journal-title":"Am J Gastroenterol"},{"key":"hep41194-bib-0043-20240114","doi-asserted-by":"crossref","first-page":"842","DOI":"10.5604\/01.3001.0010.5274","article-title":"Endoscopic management of primary sclerosing cholangitis","volume":"16","year":"2017","journal-title":"Ann Hepatol"},{"key":"hep41194-bib-0044-20240114","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.4253\/wjge.v7.i18.1268","article-title":"Advanced endoscopic imaging of indeterminate biliary strictures","volume":"7","year":"2015","journal-title":"World J Gastrointest Endosc"},{"key":"hep41194-bib-0045-20240114","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.gie.2016.03.1497","article-title":"Improving the diagnostic yield of single\u2010operator cholangioscopy\u2010guided biopsy of indeterminate biliary strictures: ROSE to the rescue? (with video)","volume":"84","year":"2016","journal-title":"Gastrointest Endosc"},{"key":"hep41194-bib-0046-20240114","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jinf.2016.10.008","article-title":"Characteristics, aetiology, antimicrobial resistance and outcomes of bacteraemic cholangitis in patients with solid tumours: a prospective cohort study","volume":"74","year":"2017","journal-title":"J Infect"}],"container-title":["Hepatology Communications"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep4.1194","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hep4.1194","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hep4.1194","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/02009842-201807000-00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T11:16:41Z","timestamp":1705231001000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/02009842-201807000-00008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,4]]},"references-count":46,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1002\/hep4.1194","relation":{},"ISSN":["2471-254X","2471-254X"],"issn-type":[{"value":"2471-254X","type":"print"},{"value":"2471-254X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,4]]}}}