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To investigate its contribution to portal hypertension in biliary cirrhosis and its underlying mechanism,\u00a0we evaluated OPV using two\u2010dimensional (2D) histopathology in liver explants from patients with biliary atresia (BA, <jats:italic>n<\/jats:italic>\u2009=\u200963), primary biliary cholangitis (PBC, <jats:italic>n<\/jats:italic>\u2009=\u200918), and hepatitis B\u2010related cirrhosis (Hep\u2010B\u2010cirrhosis, <jats:italic>n<\/jats:italic>\u2009=\u200935). Then, three\u2010dimensional (3D) OPV was measured by X\u2010ray phase\u2010contrast CT in two parallel models in rats following bile duct ligation (BDL) or carbon tetrachloride (CCl<jats:sub>4<\/jats:sub>) administration, representing biliary cirrhosis and post\u2010necrotic cirrhosis, respectively. The portal pressure was also measured in the two models. Finally, the effects of proliferative bile ducts on OPV were investigated. We found that OPV was significantly more frequent in patients with biliary cirrhosis, including BA (78.57\u2009\u00b1\u200916.45%) and PBC (60.00\u2009\u00b1\u200917.15%), than that in Hep\u2010B\u2010cirrhotic patients (29.43\u2009\u00b1\u200914.94%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). OPV occurred earlier, evidenced by the paired liver biopsy at a Kasai procedure (KP), and was irreversible even after a successful KP in the patients with BA. OPV was also significantly more frequent in the BDL models than in the CCl<jats:sub>4<\/jats:sub> models, as shown by 2D and 3D quantitative analysis. Portal pressure was significantly higher in the BDL model than that in the CCl<jats:sub>4<\/jats:sub> model. With the proliferation of bile ducts, portal venules were compressed and irreversibly occluded, contributing to the earlier and higher portal pressure in biliary cirrhosis. OPV, as a pre\u2010sinusoidal component, plays a key role in the pathogenesis of portal hypertension in biliary cirrhosis. The proliferated bile ducts and ductules gradually take up the \u2018territory\u2019 originally attributed to portal venules and compress the portal venules, which may lead to OPV in biliary cirrhosis. \u00a9 2024 The Pathological Society of Great Britain and Ireland.<\/jats:p>","DOI":"10.1002\/path.6273","type":"journal-article","created":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T04:35:36Z","timestamp":1711686936000},"page":"178-189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Obliteration of portal venules contributes to portal hypertension in biliary cirrhosis"],"prefix":"10.1002","volume":"263","author":[{"given":"Shan","family":"Shan","sequence":"first","affiliation":[{"name":"Liver Research Center, Beijing Friendship Hospital Capital Medical University  Beijing PR China"},{"name":"Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis and National Clinical Research Center of Digestive Disease  Beijing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8016-4368","authenticated-orcid":false,"given":"Xinyan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Liver Research Center, Beijing Friendship Hospital Capital Medical University  Beijing PR China"},{"name":"Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis and National Clinical Research Center of Digestive Disease  Beijing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle A","family":"Wood\u2010Trageser","sequence":"additional","affiliation":[{"name":"Starzl Transplantation Institute University of Pittsburgh  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doudou","family":"Hu","sequence":"additional","affiliation":[{"name":"The Second Department of Gastroenterology Qingdao Municipal Hospital  Qingdao Shandong PR 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