Colectomy in patients with inflammatory bowel disease and primary sclerosing cholangitis

The aim of this study was to assess risk factors for early postoperative death in patients with primary sclerosing cholangitis who are undergoing colectomy. The charts of 24 patients with primary sclerosing cholangitis who underwent colectomy between 1972 and 1990 at the Cleveland Clinic Foundation were reviewed. Clinical and laboratory data were collected and compiled to determine preoperative factors that might be helpful in predicting early postoperative death. The only factor that predicted a poor outcome was cirrhosis at the time of surgery. Three of 8 patients with cirrhosis and 0 of 16 patients without cirrhosis had an early postoperative death (P < 0.05, Fisher's exact test). We conclude that establishing whether or not patients with inflammatory bowel disease and primary sclerosing cholangitis have cirrhosis is helpful in determining the risk of colectomy.