Portal Biliopathy 001.*Khuroo MS, Yattoo GN, Zargar SA, Javid G, Dar MY, Khan BA, Boda MI: Biliary Abnormalities Associated with Extrahepatic Portal Venous Obstruction. Hepatology 1993; 17:807-13. Biliary disease is important in the clinical outcome of patients with extrahepatic portal venous obstruction because variceal sclerotherapy has prolonged the life expectancies of such patients description of so called “Portal Biliopathy”. Bilia ry Ab no rm a litie s Asso c ia te d w ith Extra he p a tic Po rta l Ve no us O b struc tio n Mo ha m m e d Sulta n Khuro o , G hula m Na b i Ya tto o , Sho w ka t Ali Za rg a r, G ul Ja vid , Mo ha mme d Yo usuf Da r, Ba shir Ahme d Kha n And Mo ha mme d Iq b a l Bo da De p a rtm e nt o f G a stro e nte ro lo g y, Institute o f Me d ic a l Sc ie nc e s, Srina g a r, Ka shm ir, Ind ia We p ro sp e c tive ly stud ie d 21 c o nse c utive p a tie nts w ith e xtra he p a tic p o rta l ve no us o b struc tio n fo r e vid e nc e o f b ilia ry tra c t d ise a se . Tw o p a tie nts w e re first se e n w ith e xtra he p a tic c ho le sta sis; a no the r ha d re c urre nt c ho la ng itis. All thre e p a tie nts w ith c linic a lly m a nife st b ina ry d ise a se w e re a d ults. Ano the r five p a tie nts ha d ic te rus o n c linic a l e xa m ina tio n. Live r func tio n te sts re ve a le d e le va te d b ilirub in le ve ls in 14 p a tie nts (66.6%), e le va te d a lka line p ho sp ha ta se le ve ls in 17 (80.9%) a nd e le va te d se rum ALT le ve ls in 8 (38.0%). End o sc o p ic re tro g ra d e c ho la ng io g ra p hy re ve a le d a b no rma l find ing s in 17 p a tie nts (80.9%). The c ha ng e s invo lve d the common bile duct (66.6%) more often than thev did the hepatic bile d uc ts (38.1%). C ho la ng io g ra p hic a b no rm a litie s inc lud e d stric ture s (52.4%), c a lib e r irre g ula rity (23.8%), se g m e nta l up stre a m d ila ta tio n (42.8%), a nd e c ta sia (9.5%), c o lla te ra l ‘ ve ins c a using e xtra lum ina l b ile d uc t im p re ssio ns (14.3%), d isp la c e me nt o f d uc ts (9.5%), a nd a ng ula tio n o f d uc ts (4.7%) a nd p runing of intra he p a tic d uc ts (9.5%) The p a tho g e ne sis of suc h c ho la ng io g ra p hic a b no rm a litie s is unkno w n. Ho w e ve r, p o ssib le fa c to rs in suc h c ha ng e s inc lud e c o lla te ra l ve ins b rid g ing the b lo c ke d p o rta l ve in, c a using , b ile d uc t im p re ssio ns; fib ro us sc a rring o f p o rta he p a tis, c a using a ng ula tio n o f b ile d uc t; a nd isc he mic injury to b ile d uc t, le a d ing to stric ture fo rm a tio n a nd c a lib e r irre g ula rity. Bilia ry d ise a se is im p o rta nt in the c linic a l o utc o m e o f p a tie nts w ith e xtra he p a tic p o rta l ve no us o b struc tio n b e c a use va ric e a l sc le ro the ra p y ha s p ro lo ng e d the life e xp e c ta nc ie s o f suc h p a tie nts. (HEPATO LO G Y 1993; 17:807-813.)