Ponsioen CY, et al. - In this prospective study, the researchers compared the efficacy and safety of balloon dilatation vs short-term stents in patients with non-end stage primary sclerosing cholangitis (PSC). From July 2011 through April 2016, an open-label trial of patients with PSC undergoing therapeutic endoscopic retrograde cholangiopancreatography (ERCP) at 9 tertiary-care centers in Europe was performed. The cumulative recurrence-free patency of the primary dominant strictures was the primary outcome. Short-term stents were not superior to balloon dilatation and were associated with a significantly higher occurrence of treatment-related serious adverse events (SAEs) in a multicenter, randomized trial of patients with PSC and a dominant stricture. In patients with PSC, balloon dilatation should be the initial treatment of choice for dominant strictures. This might be especially applicable to patients with an intact papilla.