Liver outcomes following proctocolectomy in patients with primary sclerosing cholangitis and ulcerative colitis

Background The aims of this narrative review are to examine the impact of proctocolectomy on the liver in patients with primary sclerosing cholangitis and ulcerative colitis (PSC-UC), mainly focusing on graft loss, and to compare the different proctocolectomy techniques to help determine which is the best for PSC-UC patients.Methods A literature search was performed using the online databases MEDLINE and Embase. Studies found via the search were evaluated against both inclusion and exclusion criteria by two independent reviewers (TR and JS). Relevant studies were included in the review.Results Seven studies were deemed relevant through the literature search and review process and another one was included via other sources, therefore, eight studies were included in the final review.Conclusions Proctocolectomy does not appear to have a negative impact on the liver and ileostomy appears to have better outcomes in terms of graft loss compared with ileal pouch-anal anastomosis. However, more high-quality studies on this topic are required as the existing literature is limited, and therefore, the findings should not be overinterpreted.