{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T09:29:03Z","timestamp":1760866143781},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,10,16]],"date-time":"2018-10-16T00:00:00Z","timestamp":1539648000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Portal cavernoma cholangiopathy (<jats:styled-content style=\"fixed-case\">PCC<\/jats:styled-content>), a surgical\u2010endoscopic dilemma, has not been studied comprehensively, more so in children. Our study aimed to evaluate <jats:styled-content style=\"fixed-case\">PCC<\/jats:styled-content> in children using a combination of magnetic resonance cholangiography\u2010portovenography (<jats:styled-content style=\"fixed-case\">MRC<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MRPV<\/jats:styled-content>) and endoscopic ultrasonography (<jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective cross\u2010sectional study, recruited children with extrahepatic portal venous obstruction (<jats:styled-content style=\"fixed-case\">EHPVO<\/jats:styled-content>) underwent <jats:styled-content style=\"fixed-case\">MRC<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MRPV<\/jats:styled-content> and radial array <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">PCC<\/jats:styled-content> was categorized as asymptomatic <jats:styled-content style=\"fixed-case\">PCC<\/jats:styled-content>, symptomatic and no\u2010<jats:styled-content style=\"fixed-case\">PCC<\/jats:styled-content>. Modified Llop grading was used to grade the <jats:styled-content style=\"fixed-case\">MRC<\/jats:styled-content> changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010six of 72 (92%) children had <jats:styled-content style=\"fixed-case\">PCC<\/jats:styled-content> (85% asymptomatic; 7% symptomatic) on <jats:styled-content style=\"fixed-case\">MRC<\/jats:styled-content>. Age at study and duration of disease had significant correlation (<jats:italic>r<\/jats:italic> = 0.588, <jats:italic>P<\/jats:italic> &lt; 0.001). 63% had grade <jats:styled-content style=\"fixed-case\">III MRC<\/jats:styled-content> changes. <jats:styled-content style=\"fixed-case\">MRC<\/jats:styled-content> grades and superior mesenteric vein block (64%) on <jats:styled-content style=\"fixed-case\">MRPV<\/jats:styled-content> significantly corresponded with <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content> changes (intracholedochal varices, choledochal perforators, intramural cholecystic collaterals and biliary calculi). Superior mesenteric vein non\u2010patency was a strong predictor of <jats:styled-content style=\"fixed-case\">MRC<\/jats:styled-content> biliary changes (<jats:italic>P<\/jats:italic> = 0.003, odds ratio 46.4, 95% confidence interval 4.91\u2013623.6).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A majority of <jats:styled-content style=\"fixed-case\">EHPVO<\/jats:styled-content> children have asymptomatic cholangiopathy and should be routinely evaluated for <jats:styled-content style=\"fixed-case\">PCC<\/jats:styled-content> at the time of first presentation by <jats:styled-content style=\"fixed-case\">MRC<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MRPV<\/jats:styled-content>. Additional superior mesenteric vein block with portal cavernoma results in significantly higher changes of cholangiopathy on <jats:styled-content style=\"fixed-case\">MRC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.582","type":"journal-article","created":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T07:49:27Z","timestamp":1538034567000},"page":"440-447","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Cholangiopathy in children with extrahepatic portal venous obstruction"],"prefix":"10.1002","volume":"25","author":[{"given":"Moinak","family":"Sen Sarma","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow 226014 India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Surender 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