PORTAL BILIOPATHY.

Portal biliopathy is referable to biliary ductal changesin patients with portal hypertension. It is common in portal vein thrombosis and less often in cirrhosis andnoncirrhotic portal fibrosis. The changes includestricture and dilatation of both extra-and intra-hepaticbile ducts secondary to varices encircling the CBD andgallbladder wall. When these changes becomesignificant the individual manifests with obstructivejaundice. Choledocholithiasis is a common sequel. . The precise explanation of higher frequency ofportal biliopathy in EHPVO is not clear. The biliarystricture is either secondary to ischemia, or due to aprolonged compression of the biliary tree by the portalcavernoma.

 

Based on the location and extentof cholangiographic abnormalities, a simpleclassification of portal biliopathy has been proposed.
Type I : Involvement of extrahepatic bile duct.
Type II : Involvement of intrahepatic bile ducts only.
Type IIIa : Involvement of extrahepatic bile duct andunilateral intrahepatic bile duct (Left or Right)
Type IIIb : Involvement of extrahepatic bile duct andbilateral intrahepatic bile duct.