Cirugía y Cirujanos

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board

>Journals >Cirugía y Cirujanos >Year 2014, Issue 6

Aguilar-Olivos NE, de León-Monterroso JL, Ávila-Escobedo L, López-Méndez E
Therapeutic options for portal hypertensive biliopathy: case series and literature review
Cir Cir 2014; 82 (6)

Language: Español
References: 19
Page: 680-685
PDF: 499.68 Kb.

[Full text - PDF]


Background: Portal hypertensive biliopathy is an underdiagnosed condition because only some patients have symptoms. The major clinical manifestations include cholestasis and cholangitis. The aim of this study is to present a series of cases evaluated, treated and followed at a tertiary-care public institution.
Clinical case: Four patients with portal hypertensive biliopathy were exposed to different therapeutic approaches focused on the management of portal hypertension and biliary decompression. They were followed for ~5 years. Three cases achieved a favorable outcome with symptom remission, but one patient died while attempting dilatation of the bile duct. Finally, we carried out a literature review about actual portal hypertensive biliopathy therapeutics.
Conclusions: There is currently no consensus on the optimal treatment for this condition. The goal is to decompress the biliary tree. Each case should be individually evaluated to choose the best treatment option.

Key words: Portal vein, cavernous transformation, therapeutics.


  1. Chaudhary A, Dhar P, Sarin SK, Sachdev A, Agarwal AK, Vij JC, et al. Bile duct obstruction due to portal biliopathy in extrahepatic portal hypertension: surgical management. British J Surg 1998;85(3):326-329.

  2. Mutignani M, Shah SK, Bruni A, Perri V, Costamagna G. Endoscopic treatment of extrahepatic bile duct strictures in patients with portal biliopathy carries a high risk of haemobilia: report of 3 cases. Digest Liver Disease 2002;34(8):587-591.

  3. Chandra R, Kapoor D, Tharakan A, Chaudhary A, Sarin SK. Portal biliopathy. J Gastroent Hepatol 2001;16(10):1086- 1092.

  4. Sezgin O, Oğuz D, Altintaş E, Saritaş Ü, Şahin B. Endoscopic Management of Biliary Obstruction Caused by Cavernous Transformation of the Portal Vein. Gastrointestinal Endoscopy 2003;58(4):602-608.

  5. Nagi B, Kochhar R, Bhasin D, Singh K. Cholangiopathy in extrahepatic portal venous obstruction: Radiological appearances. Acta Radiol 2000;41(6):612-615.

  6. Khuroo MS, Yattoo GN, Zargar SA, Javid G, Dar MY, Khan BA, et al. Biliary abnormalities associated with extrahepatic portal venous obstruction. Hepatology 1993;17(5):807-813.

  7. Dilawari JB, Chawla YK. Pseudosclerosing cholangitis in extrahepatic portal venous obstruction. Gut 1992;33(2):272-276.

  8. Dhiman RK, Chawla Y, Vasishta RK, Kakkar N, Dilawari JB, Trehan MS, et al. Non-cirrhotic portal fibrosis (idiopathic portal hypertension): Experience with 151 patients and a review of the literature. J Gastroenterol Hepatol 2002;17(1):6-16.

  9. Condat B, Vilgrain V, Asselah T, O’Toole D, Rufat P, Zappa M, et al. Portal cavernoma-associated cholangiopathy: A clinical and MR cholangiography coupled with MR portography imaging study. Hepatology 2003;37(6):1302-1308.

  10. D’Souza MA, Desai D, Joshi A, Abraham P, Shah SR. Bile duct stricture due to caused by portal biliopathy: Treatment with one-stage portal-systemic shunt and biliary bypass. Indian J Gastroenterol 2009;28(1):35-37.

  11. Malkan GH, Bhatia SJ, Bashir K, Khemani R, Abraham P, Gandhi MS, et al. Cholangiopathy associated with portal hypertension: diagnostic evaluation and clinical implications. Gastrointest Endosc 1999;49(3 Pt 1):344-348.

  12. Dhiman RK, Behera A, Chawla YK, Dilawari JB, Suri S. Portal hypertensive biliopathy. Gut 2007;56(7):1001-1008.

  13. Filipponi F, Urbani L, Catalano G, Iaria G, Biancofiore G, Cioni R, et al. Portal biliopathy treated by liver transplantation. Transplantation 2004;77(2):326-327.

  14. Dumortier J, Vaillant E, Boillot O, Poncet G, Henry L, Scoazec JY, et al. Diagnosis and Treatment of Biliary Obstruction Caused by Portal Cavernoma. Endoscopy 2003;35(5):446- 450.

  15. Vibert E, Azoulay D, Aloia T, Pascal G, Veilhan LA, Adam R, et al. Therapeutic Strategies in Symptomatic Portal Biliopathy. Ann Surg 2007;246(1):97-104.

  16. Agarwal AK, Sharma D, Singh S, Agarwal S, Girish SP. Portal biliopathy: a study of 39 surgically treated patients. HPB(Oxford) 2011;13(1):33-39.

  17. DeLeve LD, Valla DC, Garcia-Tsao G. Vascular disorders of the liver. Hepatology 2009;49(5):1729-1764.

  18. Qi X, Han G, Yin Z, He C, Wang J, Guo W, et al. Transjugular Intrahepatic Portosystemic Shunt for Portal Cavernoma with Symptomatic Portal Hypertension in Non-cirrhotic Patients. Dig Dis Sci 2012;57(4):1072-1082.

  19. Senzolo M, Cholongitas E, Tibballs J, Patch D, Triantos CK, Samonakis D, et al. Relief of biliary obstruction due to portal vein cavernoma using a transjugular intrahepatic portosystemic shunt (TIPS) without the need for long-term stenting. Endoscopy 2006;38(7):760.

>Journals >Cirugía y Cirujanos >Year 2014, Issue 6

· Journal Index 
· Links 
Copyright 2010