Therapeutic approaches for portal biliopathy: A systematic review.

摘要: Portal biliopathy (PB) is defined as the presence of biliary abnormalities in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and cavernoma (PC). The pathogenesis PB due to ab extrinseco compression bile ducts by PC and/or ischemic damage secondary an altered vascularization EHPVO PC. Although asymptomatic can be frequently seen magnetic resonance cholangiopancreatography (77%-100%), only a part these (5%-38%) are symptomatic. Clinical presentation includes jaundice, cholangitis, cholecystitis, abdominal pain, cholelithiasis. In this subset required specific treatment. Different therapeutic approaches aimed diminish hypertension treat strictures available. order decompress PC, surgical porto-systemic shunt or transjugular intrahepatic performed, treatment on stenosis endoscopic (Endoscopic retrograde sphincterotomy, balloon dilation, stone extraction, stent placement) (bilioenteric anastomosis, cholecystectomy) approaches. Definitive often requires multiple combined interventions both vascular system. Liver transplantation considered cirrhosis, recurrent cholangitis unsuccessful control hypertension.