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Year : 2015  |  Volume : 4  |  Issue : 1  |  Page : 44-51

Intraductal ultrasonographic anatomy of biliary varices in patients with portal hypertension

1 Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
2 Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Japan
3 Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan

Correspondence Address:
Atsushi Irisawa
Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2303-9027.151346

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Background and Objectives: The term, portal biliopathy, denotes various biliary abnormalities, such as stenosis and/or dilatation of the bile duct, in patients with portal hypertension. These vascular abnormalities sometimes bring on an obstructive jaundice, but they are not clear which vessels participated in obstructive jaundice. The aim of present study was clear the bile ductal changes in patients with portal hypertension in hopes of establishing a therapeutic strategy for obstructive jaundice caused by biliary varices. Materials and Methods: Three hundred and thirty-seven patients who underwent intraductal ultrasound (IDUS) during endoscopic retrograde cholangiography for biliary abnormalities were enrolled. Portal biliopathy was analyzed using IDUS. Results: Biliary varices were identified in 11 (2.7%) patients. IDUS revealed biliary varices as multiple, hypoechoic features surrounding the bile duct wall. These varices could be categorized into one of two groups according to their location in the sectional image of bile duct: epicholedochal and paracholedochal. Epicholedochal varices were identified in all patients, but paracholedochal varices were observed only in patients with extrahepatic portal obstruction. Conclusion: IDUS was useful to characterize the anatomy of portal biliopathy in detail.

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