Sigmoidectomy vs TPC in PSC-IBD with left-sided colitis

What is known

• The available studies address total (procto)colectomy, restorative proctocolectomy with [ileal pouch-anal anastomosis](https://Pouchology.org (patient sites: Pouchy.org)/), and end ileostomy. ^1–4

What is unknown / caveats

• The retrieved evidence does not compare segmental sigmoidectomy against total proctocolectomy for liver outcomes in PSC-IBD, so no answer to this specific question can be drawn from it.
• Segmental resection for diverticular disease is not evaluated as a liver-outcome intervention.

References

1. Matar AJ, Falconer E, LaBella M, Kapadia MR, Justiniano CF, Olortegui KS, Steinhagen R, Schultz K, Pratap A, Leeds I, Weaver L, Gaertner W, Finger EB, Thompson M, Fair L, Fichera A, Lovasik BP, Chapman WC, McGeoch CLB, Camacho MC, Kazimi M, Kim SC, Shaffer VO, Srinivasan JK. Long-term Outcomes Following Colectomy and Liver Transplantation for Inflammatory Bowel Disease With Primary Sclerosing Cholangitis. Ann Surg. 2026;283:707-714. PMID: 39258375.

2. Maspero M, Holubar SD, Raj R, Yilmaz S, Prien C, Lavryk O, Pita A, Hashimoto K, Steele SR, Hull TL. Ileal Pouch-anal Anastomosis in Primary Sclerosing Cholangitis-inflammatory Bowel Disease (PSC-IBD): Long-term Pouch and Liver Transplant Outcomes. Ann Surg. 2023;278:961-968. PMID: 37477000.

3. Schabl L, Holubar SD, Maspero M, Steele SR, Hull T. Ileal pouch-anal anastomosis and end ileostomy result in equivalent graft survival following liver transplantation for inflammatory bowel disease-primary sclerosing cholangitis. Tech Coloproctol. 2024;28:113. PMID: 39167239.

4. Dunleavy KA, Santiago P, Forde G, Harmsen WS, McKenna NP, Coelho-Prabhu N, Shawki S, Raffals L. Total Proctocolectomy vs Subtotal/total Colectomy for Neoplasia in Patients With Inflammatory Bowel Disease and Primary Sclerosing Cholangitis. Inflamm Bowel Dis. 2024;30:1935-1945. PMID: 38142126.

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Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct.