Clinical features of portal biliopathy

Wenqian GENG; Chong WANG; Hang LI; Junqi NIU; Fang XU

doi:10.3969/j.issn.1001-5256.2023.11.020

Volume 39 Issue 11

Nov. 2023

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Journal of Clinical Hepatology > 2023 > 39(11): 2651-2656

PDF( 781 KB)

Clinical features of portal biliopathy

DOI: 10.3969/j.issn.1001-5256.2023.11.020

Department of Hepatology，The First Hospital of Jilin University，Changchun 130000，China

Research funding:

Tianqing Liver Disease Research Fund of China Foundation for Hepatitis Prevention and Control (20210118)

More Information

Corresponding author: XU fang， xu_fang@jlu.edu.cn （ORCID： 0000-0001-5159-5989）
Received Date: 2023-02-01
Accepted Date: 2023-03-17
Published Date: 2023-11-28

Abstract

Abstract

Objective This article aims to investigate the clinical features of portal biliopathy （PB） patients， in order to improve the understanding of PB. Methods Clinical data were collected from 22 patients who were diagnosed with PB in recent years in The First Hospital of Jilin University， and an analysis was performed for their clinical manifestations， liver function， abdominal color Doppler ultrasound， abdominal CT， and hepatobiliary magnetic resonance imaging. The imaging manifestations of biliary tract abnormalities were described， as well as the type of collateral circulation and the location of thrombosis. Results As for the initial symptom in these 22 patients， three were 11 patients with gastrointestinal bleeding， 5 with abdominal distension， 3 with abdominal pain， 1 with fever， 1 with abdominal discomfort， and 1 with gingival bleeding. There were 3 patients with an increase in aspartate aminotransferase， 4 with an increase in alanine aminotransferase， 4 with an increase in gamma-glutamyl transpeptidase， 7 with an increase in alkaline phosphatase， 8 with a reduction in cholinesterase， 9 with a reduction in albumin， 2 with an increase in globulin， and 5 with an increase in total bilirubin. Among the 22 patients， 20 had cavernous transformation of the portal vein， and 2 had portal vein thrombosis without cavernous transformation. All 22 patients had bile duct abnormalities， among whom 2 had extrahepatic bile duct abnormalities alone， 12 had intrahepatic bile duct dilatation alone， and 8 had dilatation of both intrahepatic and extrahepatic bile ducts. Varices at different sites were observed in 20 patients， among whom 19 had esophageal and gastric varices and 1 had peri-gallbladder varices， and no varices was observed in the superior mesenteric vein or the splenic vein. Conclusion There are no typical clinical symptoms and changes in liver function parameters in patients with PB， but radiological examination may show dilatation， stenosis， or malformation of the bile ducts at different parts. Therefore， it is necessary to expand the sample size to further explore the diagnosis and treatment of PB.
- Biliary Tract Diseases,
- Ultrasonography， Doppler， Color,
- Magnetic Resonance Imaging,
- Therapeutics

FullText(HTML)

References(21)

References

[1]	DHIMAN RK, BEHERA A, CHAWLA YK, et al. Portal hypertensive biliopathy[J]. Gut, 2007, 56( 7): 1001- 1008. DOI: 10.1136/gut.2006.103606.
[2]	XU F, WEN XY, ZHANG L, et al. Portal ductopathy[J]. Chin J Hepatol, 2014, 22( 11): 871- 873. DOI: 10.3760/cma.j.issn.1007-3418.2014.011.016. 许芳, 温晓玉, 张磊, 等. 门静脉性胆道病[J]. 中华肝脏病杂志, 2014, 22( 11): 871- 873. DOI: 10.3760/cma.j.issn.1007-3418.2014.011.016.
[3]	CHANDRA R, KAPOOR D, THARAKAN A, et al. Portal biliopathy[J]. J Gastroenterol Hepatol, 2001, 16( 10): 1086- 1092. DOI: 10.1046/j.1440-1746.2001.02562.x.
[4]	HE ZP, FAN LJ. Diagnosis and treatment of portal biliopathy[J]. Hepatobiliary Pancreat Dis Int, 2002, 1( 4): 581- 586.
[5]	JIANG P, WANG SP, LIU YH. A case of portal biliopathy[J]. J Clin Hepatol, 2022, 38( 2): 430- 432. DOI: 10.3969/j.issn.1001-5256.2022.02.034. 姜朋, 王树鹏, 刘亚辉. 门静脉性胆道病1例报告[J]. 临床肝胆病杂志, 2022, 38( 2): 430- 432. DOI: 10.3969/j.issn.1001-5256.2022.02.034.
[6]	SHIN SM, KIM S, LEE JW, et al. Biliary abnormalities associated with portal biliopathy: Evaluation on MR cholangiography[J]. AJR Am J Roentgenol, 2007, 188( 4): W341- W347. DOI: 10.2214/AJR.05.1649.
[7]	PANG SJ, YE QW, SHI Y, et al. Progress in clinical diagnosis and treatment of portal hypertensive biliary disease[J]. J Hepatopancreatobiliary Surg, 2015, 27( 5): 431- 433. DOI: 10.11952/j.issn.1007-1954.2015.05.027. 庞书杰, 叶庆旺, 施洋, 等. 门脉高压性胆病临床诊疗进展[J]. 肝胆胰外科杂志, 2015, 27( 5): 431- 433. DOI: 10.11952/j.issn.1007-1954.2015.05.027.
[8]	CHATTOPADHYAY S, NUNDY S. Portal biliopathy[J]. World J Gastroenterol, 2012, 18( 43): 6177- 6182. DOI: 10.3748/wjg.v18.i43.6177.
[9]	ITARE VB, IMANIRAD D, ALMAGHRABY A. Portal cholangiopathy: An uncommon cause of right upper quadrant pain[J]. Cureus, 2020, 12( 9): e10281. DOI: 10.7759/cureus.10281.
[10]	DHIMAN R, CHAWLA Y, DUSEJA A, et al. Portal hypertensive biliopathy(PHB) in patients with extrahepatic portal venous obstruction(EHPVO)[J]. J Gastroenterol Hepatol, 2006, 21: A222.
[11]	TACCHELLA G, GJERMENI O, CRINÓ SF, et al. Portal hypertensive biliopathy and bile duct varices presenting as jaundice[J]. Endoscopy, 2021, 53( 12): E442- E443. DOI: 10.1055/a-1337-1994.
[12]	NUNOI H, HIROOKA M, OCHI H, et al. Portal biliopathy diagnosed using color Doppler and contrast-enhanced ultrasound[J]. Intern Med, 2013, 52( 10): 1055- 1059. DOI: 10.2169/internalmedicine.52.8848.
[13]	KHUROO MS, RATHER AA, KHUROO NS, et al. Portal biliopathy[J]. World J Gastroenterol, 2016, 22( 35): 7973- 7982. DOI: 10.3748/wjg.v22.i35.7973.
[14]	DING HG, OUYANG Y. Clinical manifestations of portal hypertension[J]. Beijing Med J, 2011, 33( 12): 1014- 1017. DOI: 10.15932/j.0253-9713.2011.12.021. 丁惠国, 欧阳颖. 门脉高压症临床表现[J]. 北京医学, 2011, 33( 12): 1014- 1017. DOI: 10.15932/j.0253-9713.2011.12.021.
[15]	OZKAVUKCU E, ERDEN A, ERDEN I. Imaging features of portal biliopathy: Frequency of involvement patterns with emphasis on MRCP[J]. Eur J Radiol, 2009, 71( 1): 129- 134. DOI: 10.1016/j.ejrad.2008.03.007.
[16]	BESA C, CRUZ JP, HUETE A, et al. Portal biliopathy: A multitechnique imaging approach[J]. Abdom Imaging, 2012, 37( 1): 83- 90. DOI: 10.1007/s00261-011-9765-2.
[17]	WALSER EM, RUNYAN BR, HECKMAN MG, et al. Extrahepatic portal biliopathy: Proposed etiology on the basis of anatomic and clinical features[J]. Radiology, 2011, 258( 1): 146- 153. DOI: 10.1148/radiol.10090923.
[18]	KHAN MR, TARIQ J, RAZA R, et al. Portal hypertensive biliopathy: Review of pathophysiology and management[J]. Trop Gastroenterol, 2012, 33( 3): 173- 178. DOI: 10.7869/tg.2012.44.
[19]	D’SOUZA SL, DAVENPORT MS, ELTA GH. Biliary stricture secondary to portal biliopathy[J]. Gastrointest Endosc, 2013, 78( 6): 942- 944. DOI: 10.1016/j.gie.2013.07.052.
[20]	SEZGIN O, OĞUZ D, ALTINTAŞ E, et al. Endoscopic management of biliary obstruction caused by cavernous transformation of the portal vein[J]. Gastrointest Endosc, 2003, 58( 4): 602- 608. DOI: 10.1067/s0016-5107(03)01975-8.
[21]	CHATTOPADHYAY S, GOVINDASAMY M, SINGLA P, et al. Portal biliopathy in patients with non-cirrhotic portal hypertension: Does the type of surgery affect outcome?[J]. HPB, 2012, 14( 7): 441- 447. DOI: 10.1111/j.1477-2574.2012.00473.x.

Relative Articles

[1]	Yuan WEN, Juanjuan ZHU. Clinical efficacy of double plasma molecular absorption system and sequential plasma exchange combined with continuous renal replacement therapy in treatment of acute-on-chronic liver failure with acute kidney injury[J]. Journal of Clinical Hepatology, 2024, 40(3): 556-561. doi: 10.12449/JCH240319
[2]	Jie LU, Dingchun LI, Ye LIU, Linna YUAN, Zhiwen DUAN, Wu LI. Clinical efficacy of low-dose plasma exchange combined with double plasma molecular absorption system/hemoperfusion in treatment of acute-on-chronic liver failure[J]. Journal of Clinical Hepatology, 2022, 38(11): 2526-2531. doi: 10.3969/j.issn.1001-5256.2022.11.017
[3]	Lan XiaoQin, Ji YaLi, Chen JinJun, Zhou FuYuan, Wen WeiQun. Effect of artificial liver support therapy on the short-term prognosis of patients with liver failure in the plateau stage: A stratified analysis based on Model for End-Stage Liver Disease score[J]. Journal of Clinical Hepatology, 2020, 36(9): 2005-2009. doi: 10.3969/j.issn.1001-5256.2020.09.019
[4]	Yao YunHai, Gan JianHe, Zhao WeiFeng. Effect of plasma exchange combined with continuous renal replacement therapy on the prognosis of patients with HBV-related acute-on-chronic liver failure and acute kidney injury[J]. Journal of Clinical Hepatology, 2019, 35(5): 1065-1069. doi: 10.3969/j.issn.1001-5256.2019.05.026
[5]	Guo XiJu, Guo WeiBo, Zhang JiaChang, Lu YaJing, Yang Yan. Clinical effect of double plasma molecular absorption system in treatment of liver failure due to hyperthyroidism: A case report[J]. Journal of Clinical Hepatology, 2018, 34(7): 1526-1528. doi: 10.3969/j.issn.1001-5256.2018.07.033
[6]	Wu YiChen, Yao HongYu, Wang KaiLi, Jiang QiYu, Liu Chang, Xing HanQian, Liu SuXia, You ShaoLi, Zhao Jun. Effect of plasma exchange on bioactivity of peripheral blood CD34+ cells in patients with acute-on-chronic (subacute) liver failure[J]. Journal of Clinical Hepatology, 2018, 34(11): 2383-2387. doi: 10.3969/j.issn.1001-5256.2018.11.023
[7]	Li Shuang, Chen Yu. Coping with shortage of plasma-The new therapeutic pattern of non-bioartificial liver[J]. Journal of Clinical Hepatology, 2017, 33(9): 1687-1692. doi: 10.3969/j.issn.1001-5256.2017.09.012
[8]	Zhou Jian, Wan Hong, Yang ZhengMao, Wang ZhaoXun. Clinical effect of plasma perfusion combined with plasma exchange in treatment of patients with acute-on-chronic liver failure[J]. Journal of Clinical Hepatology, 2017, 33(4): 715-718. doi: 10.3969/j.issn.1001-5256.2017.04.023
[9]	Hou HuanRong, Shang Jia, Kang Yi, Li YuKui, Ceng YanLi, Ding GangQiang, Mao ZhongShan, Xiao ErHui. Clinical effect of plasma exchange combined with hemofiltration in patients with subacute liver failure induced by antitubercular agents[J]. Journal of Clinical Hepatology, 2016, 32(2): 342-346. doi: 10.3969/j.issn.1001-5256.2016.02.030
[10]	Zhang LiangJie, Chen HuiJuan, Zhao ShouSong. Effects of artificial liver plasma exchange on cytokines in patients with liver failure[J]. Journal of Clinical Hepatology, 2015, 31(4): 578-581. doi: 10.3969/j.issn.1001-5256.2015.04.024
[11]	Wu ShaoHong, Gan JianHe, Huang XiaoPing, Lin Hua, Lu NianFang, Wu JiangQuan, Zheng RuiQiang. Clinical effect of albumin dialysis combined with plasma perfusion in treatment of liver failure[J]. Journal of Clinical Hepatology, 2014, 30(5): 434-437. doi: 10.3969/j.issn.1001-5256.2014.05.013
[12]	Liu XiaoHui, Guo HaiQing, Zhang Jing, Duan ZhongPing. Progress in technology and clinical application of non- bioartificial liver support system[J]. Journal of Clinical Hepatology, 2013, 29(9): 661-665. doi: 10.3969/j.issn.1001-5256.2013.09.007
[13]	You ShaoLi, Liu HongLing, Rong YiHui, Zhu Bing, Zang Hong, Liu WanShu, Wan ZhiHong, Mao PanYong, Xin ShaoJie. Preliminary investigation of hybrid bioartificial liver support system in treatment of HBV- related acute- on- chronic liver failure[J]. Journal of Clinical Hepatology, 2013, 29(9): 685-688. doi: 10.3969/j.issn.1001-5256.2013.09.013
[14]	Hu QiJiang, Jiang YingAn. Evaluation of the therapeutic efficacy of lamivudine combined with plasma exchange for treating acute-on-chronic hepatitis B liver failure [J]. Journal of Clinical Hepatology, 2013, 29(2): 107-109.
[15]	Zhou Jian, Wan Hong. Relationship between changes in serum cytokine levels after artificial liver therapy and clinical prognosis in patients with liver failure[J]. Journal of Clinical Hepatology, 2013, 29(7): 535-537. doi: 1001-5256 (2013) 07-0535-03
[16]	Zhang AiMin, You ShaoLi, Wan ZhiHong, Rong YiHui, Zhu Bing, Zang Hong, Xin ShaoJie. Combination therapy of plasma perfusion, plasma exchange, and entecavir in patients with hepatitis B acute-on-chronic liver failure[J]. Journal of Clinical Hepatology, 2012, 28(10): 744-747.
[17]	Zhang WenHua, Jia WenLing, Zhou ZiYing, Tang HaiTao, Wang FengMei. Investigation on the method and safety of the non-heparinized plasma exchange therapy in treating patients with hepatic failure[J]. Journal of Clinical Hepatology, 2012, 28(1): 50-52.
[18]	Liao JinMao, Li ZhuoRi, Hu XiaoXuan. The therapeutic effect of plasma exchange therapy in patients with severe hepatitis[J]. Journal of Clinical Hepatology, 2012, 28(4): 302-304.
[19]	Liu ZhiHong, Jiang JianNing, Luo GuangHan, Wu JiZhou, Deng YiMing, Su MingHua, Wu JianLin, Zhang Lu. The value of MELD score for evaluation of plasma exchange in patients with liver failure[J]. Journal of Clinical Hepatology, 2010, 26(6): 615-617.

Supplements(0)

Cited By

Cited by

Periodical cited type(6)

1.	胡泉东，周斌，李美静. 高血压合并NAFLD患者发生肝纤维化的影响因素及治疗干预. 齐齐哈尔医学院学报. 2024(03): 230-233 .
2.	张艺璇，陈春梅，朱有为，朱益，何思源，刘彦丽，王娜，蔡军，谢斌，张伟波. 上海市社区严重精神障碍患者肝功能异常状况及其相关因素研究. 上海预防医学. 2024(11): 1018-1025 .
3.	岳思冉，谭宜云，谢峰，张林芳，张峰玮，汪天英，郎卿，张磊，王健英，刘保成，王睿瑞. 上海社区老年人非酒精性脂肪性肝病、高血压共病机制及中医体质分布规律研究. 上海中医药杂志. 2022(05): 39-43 .
4.	杜婧，丁文波，武心萍，李杰，韩敏，魏国利. 基于多因素Logistic回归分析评分模型对年轻高血压患者急性脑梗死预测价值. 临床军医杂志. 2022(11): 1183-1187 .
5.	管佩霞，李志强，毛倩，王喆，刘玉洁，朱高培，石福艳，王素珍. 基于关联规则的脂肪肝与5种慢性代谢性疾病的关联性分析. 现代预防医学. 2021(17): 3242-3246+3253 .
6.	安欣，刘鲁豫，王成凯. 2型糖尿病患者尿微量白蛋白肌酐比值与非酒精性脂肪性肝病相关性分析. 陕西医学杂志. 2021(11): 1416-1419 .

Other cited types(10)

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(3)

Get Citation

PDF

XML

Article Metrics

Article views (408) PDF downloads(43)

Clinical features of portal biliopathy

DOI: 10.3969/j.issn.1001-5256.2023.11.020