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Semin Liver Dis 2019; 39(04): 502-512
DOI: 10.1055/s-0039-1693514
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Portal Hypertensive Biliopathy in Adult Patients: Findings and Interventional Radiologic Treatment—A Single-Center Experience

Alberta Cappelli
1   Department of Diagnostic Medicine and Prevention, Radiology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
,
Francesco Modestino
1   Department of Diagnostic Medicine and Prevention, Radiology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
,
Cristina Mosconi
1   Department of Diagnostic Medicine and Prevention, Radiology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
,
Caterina De Benedittis
1   Department of Diagnostic Medicine and Prevention, Radiology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
,
Antonio Bruno
1   Department of Diagnostic Medicine and Prevention, Radiology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
,
Dimitris Papadopoulos
2   Radiology Unit, “C. A. Pizzardi” Maggiore Hospital, Bologna, Italy
,
Giovanni Vitale
3   Department of Organ Failure and Transplantation, Internal Medicine, S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy
,
Alessandro Cucchetti
4   General and Oncology Surgery, Morgagni-Pierantoni Hospital, Forli, Italy
5   Department of Medical & Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna, Bologna, Italy
,
Sonia Berardi
3   Department of Organ Failure and Transplantation, Internal Medicine, S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy
,
Maria Cristina Morelli
3   Department of Organ Failure and Transplantation, Internal Medicine, S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy
,
Rita Golfieri
1   Department of Diagnostic Medicine and Prevention, Radiology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
04 July 2019 (online)

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Abstract

The aim of this study was to evaluate the morphologic appearance, the clinical scenario, and the outcomes of patients with portal hypertensive biliopathy (PHB), particularly in the symptomatic subgroup treated with interventional radiology (IR) procedures. The outcome of 20 patients with PHB were retrospectively reviewed over a 5-year period. In all cases, the extrahepatic portal vein occlusion (EHPVO) and the compensatory cavernomatosis was the cause of PHB. Eight out of 20 patients had severe symptoms (jaundice and bleeding). Five out of these eight patients were successfully treated with IR procedures. PHB is a rare but serious complication of PH from EHPVO. IR treatments are highly effective in controlling symptoms. Moreover, IR procedures, as drainage and transjugular intrahepatic portosystemic shunt placement, are the first-line treatment in cases of life-threatening bleeding from ruptures of the varices.

Keywords

portal biliopathy - portal vein obstruction - portal cavernoma - biliary obstruction

Author Contributions

Concept and design of the study, drafting, and writing of the manuscript: Alberta Cappelli, Francesco Modestino, Cristina Mosconi, Rita Golfieri. Extraction of data: Cristina Mosconi, Caterina De Benedittis, Antonio Bruno, Dimitris Papadopoulos, Giovanni Vitale, Alessandro Cucchetti, Sonia Berardi, Maria Cristina Morelli. Revision of important intellectual content: all authors. All authors approved the final version of the manuscript. All authors had full access to all of the data (including statistical reports and tables) in the study and took responsibility for the integrity of the data and the accuracy of the data analysis.