Portal biliopati'de Doppler ultrasonografi ile kolanjiografi bulguları ilişkisizdir

Abstract

Background and Aims: Biliary changes caused by cavernous transformation, which develops after portal vein thrombosis, are referred to as portal biliopathy. It may involve extrahepatic or intrahepatic bile ducts, or both. We aimed to reveal whether findings on Doppler ultrasound are related to changes seen on cholangiography in patients with portal vein thrombosis who developed cavernous transformation. Materials and Methods: A total of 22 patients [15 males, mean age 40,28±12,02 years] with portal biliopathy who underwent endoscopic retrograde cholangiopancreatography procedure for the relief of biliary obstruction were examined with Doppler ultrasound by radiologists who were blinded to the endoscopic retrograde cholangiopancreatography findings. The data from both examinations were compared, particularly the relationship of extrahepatic and intrahepatic main bile ducts with the site of thrombosis and the presence of collaterals. Results: We found biliary strictures in the right hepatic duct in 3 patients, in the left hepatic duct in 2 patients and in the extrahepatic bile ducts in all patients by endoscopic retrograde cholangiopancreatography. On the other hand, Doppler ultrasound showed that a significant number of patients had no biliary stricture even in the presence of dilated collateral veins accompanying the bile ducts (next to the extrahepatic bile duct in all patients, to the right hepatic duct in 12 patients and to the left hepatic duct in 9 patients). Conclusions: We found that there was no relation between the Doppler ultrasound findings of portal veins and collaterals and the site of the stricture detected by endoscopic retrograde cholangiopancreatography. It may be concluded that there are some factors other than compression of collateral veins that play a role in the pathogenesis of portal biliopathy.