Long Term Outcomes of Patients with Significant Biliary Obstruction Due to Portal Cavernoma Cholangiopathy and Extra-Hepatic Portal Vein Obstruction (EHPVO) With No Shuntable Veins.
J Clin Exp Hepatol
; 7(4): 328-333, 2017 Dec.
Article
em En
| MEDLINE
| ID: mdl-29234198
ABSTRACT
AIMS:
The natural history of portal cavernoma cholangiopathy (PCC) in patients with significant biliary obstruction (SBO) who cannot undergo shunt surgery, is not known. We therefore, analyzed data of patients of extra-hepatic portal venous obstruction (EHPVO) with PCC.METHODS:
Prospectively recorded details of 620 (age 21.2 [11.4] years; 400 [65%] males) patients with primary EHPVO were reviewed. Outcomes (hepatic decompensation/mortality) of patients with PCC and SBO without shuntable veins were noted at follow up of 7 [4-11] years.RESULTS:
Ninety-seven of 620 (15.6% [60 men]) EHPVO patients had PCC-SBO. Of these 57 did not have shuntable veins. The median duration from any index symptom to symptomatic PCC was 7 (0-24) years and from index bleed to symptomatic PCC was and 12 (5-24) years, respectively. Thirteen patients underwent endoscopic retrograde cholangiography; nine repeatedly over 7 (4-10) years. Decompensation was seen in 5 patients. Presentation other than variceal bleed was associated with hepatic decompensation (5/19 versus 0/38, P = 0.003).CONCLUSIONS:
Majority of patients with PCC-SBO do not have shuntable veins, and may have good long-term outcomes. Patients presenting with variceal bleed have low chance of decompensation. Symptomatic PCC appears to be a late event in EHPVO.
CT, computed tomography; EHPVO, extra-hepatic portal venous obstruction; MRCP, magnetic resonance cholangiopancreatography; PCC, portal cavernoma cholangiopathy; PSSS, portosystemic shunt surgery; SBO, significant biliary obstruction; SMV, superior mesenteric vein; SV, splenic vein; US, ultrasound; cirrhosis of liver; portal biliopathy; portal hypertension; porto-systemic shunts; secondary biliary cirrhosis
Texto completo:
1
Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article