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Portal biliopathy.
Khuroo, Mohammad S; Rather, Ajaz A; Khuroo, Naira S; Khuroo, Mehnaaz S.
Affiliation
  • Khuroo MS; Mohammad S Khuroo, Sher-I-Kashmir Institute of Medical Sciences, Srinagar Kashmir 190010, India.
  • Rather AA; Mohammad S Khuroo, Sher-I-Kashmir Institute of Medical Sciences, Srinagar Kashmir 190010, India.
  • Khuroo NS; Mohammad S Khuroo, Sher-I-Kashmir Institute of Medical Sciences, Srinagar Kashmir 190010, India.
  • Khuroo MS; Mohammad S Khuroo, Sher-I-Kashmir Institute of Medical Sciences, Srinagar Kashmir 190010, India.
World J Gastroenterol ; 22(35): 7973-82, 2016 Sep 21.
Article in En | MEDLINE | ID: mdl-27672292
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).
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Portal Vein / Biliary Tract / Cholestasis / Cholangiopancreatography, Endoscopic Retrograde Type of study: Diagnostic_studies / Etiology_studies Limits: Humans Language: En Journal: World J Gastroenterol Journal subject: GASTROENTEROLOGIA Year: 2016 Document type: Article Affiliation country: India

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Portal Vein / Biliary Tract / Cholestasis / Cholangiopancreatography, Endoscopic Retrograde Type of study: Diagnostic_studies / Etiology_studies Limits: Humans Language: En Journal: World J Gastroenterol Journal subject: GASTROENTEROLOGIA Year: 2016 Document type: Article Affiliation country: India
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