Portal Biliopathy

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2016 Sep 28

PMID 27672292

Citations 12

Authors

Mohammad S Khuroo

Ajaz A Rather

Naira S Khuroo

Mehnaaz S Khuroo

Affiliations

Soon will be listed here.

Abstract

Portal biliopathy refers to cholangiographic abnormalities which occur in patients with portal cavernoma. These changes occur as a result of pressure on bile ducts from bridging tortuous paracholedochal, epicholedochal and cholecystic veins. Bile duct ischemia may occur due prolonged venous pressure effect or result from insufficient blood supply. In addition, encasement of ducts may occur due fibrotic cavernoma. Majority of patients are asymptomatic. Portal biliopathy is a progressive disease and patients who have long standing disease and more severe bile duct abnormalities present with recurrent episodes of biliary pain, cholangitis and cholestasis. Serum chemistry, ultrasound with color Doppler imaging, magnetic resonance imaging with magnetic resonance cholangiopancreatography and magnetic resonance portovenography are modalities of choice for evaluation of portal biliopathy. Endoscopic retrograde cholangiography being an invasive procedure is indicated for endotherapy only. Management of portal biliopathy is done in a stepwise manner. First, endotherapy is done for dilation of biliary strictures, placement of biliary stents to facilitate drainage and removal of bile duct calculi. Next portal venous pressure is reduced by formation of surgical porto-systemic shunt or transjugular intrahepatic portosystemic shunt. This causes significant resolution of biliary changes. Patients who persist with biliary symptoms and bile duct changes may benefit from surgical biliary drainage procedures (hepaticojejunostomy or choledechoduodenostomy).

Citing Articles

Imaging in Vascular Liver Diseases.

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Acute acalculous cholecystitis with portal cavernoma: A case report with literature review.

Vo D, Ha T, Le H, Doan D, Vo T, Mai T Radiol Case Rep. 2024; 19(8):3349-3353.

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My 40-Year Encounter with ERCP: A Saga of Service, Syndromes, and Solutions.

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Vascular complications of chronic pancreatitis and its management.

Walia D, Saraya A, Gunjan D World J Gastrointest Surg. 2023; 15(8):1574-1590.

PMID: 37701688 PMC: 10494584. DOI: 10.4240/wjgs.v15.i8.1574.

Bad Connection: Stent-to-Stent Fistulization After Common Bile Duct and Transjugular Intrahepatic Portosystemic Shunt Stenting.

Issac A, Youngblood A, Enunwa C, Veeramachaneni H, Khare A, Razvi M ACG Case Rep J. 2023; 10(5):e01041.

PMID: 37168506 PMC: 10166329. DOI: 10.14309/crj.0000000000001041.

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