“…For example, because the cholangiographic characteristics of extrahepatic CCA can imitate the stricturing lesions of PSC, the diagnosis of the former in these patients is difficult or at times impossible. Retrospective studies revealed risk factors associated with the development of CCA in PSC patients, including jaundice, 5 pruritus, 5 fatigue, 5 smoking, 4 alcohol, 6 variceal bleeding, 2 long history of inflammatory bowel disease, 5 and chronic ulcerative colitis with colon cancer/dysplasia. 8 However, these factors were not confirmed between the different studies.…”