{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T23:27:37Z","timestamp":1769815657224,"version":"3.49.0"},"reference-count":29,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2013,11,18]],"date-time":"2013-11-18T00:00:00Z","timestamp":1384732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Portal biliopathy (<jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content>) is a rare condition in which portal hypertension because of extrahepatic portal vein obstruction can lead to biliary abnormalities, with some patients developing obstructive jaundice. At present, there is no international consensus on the management of <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content>. We present the experience of an <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ustralian tertiary referral hospital with the diagnosis and management of <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content>, and compare this with reported international experience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The records of nine patients presenting with <jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content> between <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>une 2003 and <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>arch 2012 were reviewed and analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients had portal hypertension because of portal vein thrombosis, with seven patients showing cavernous transformation of the portal vein. Biliary abnormality presented with jaundice (3\/9), abdominal pain (2\/9) or without symptoms (3\/9). All patients developed a cholestatic pattern of liver function tests (<jats:styled-content style=\"fixed-case\">LFTs<\/jats:styled-content>). First\u2010line endoscopic management was employed in 7 of 8 symptomatic patients. Four patients required endoscopic management alone (sphincterotomy alone (1\/9), single stent (2\/9), repeated stent changes (1\/9)\u2009), while four required second\u2010line surgical intervention (portosystemic shunt (1\/9), bilioenteric anastomosis (3\/9)\u2009). All patients were well, with stable <jats:styled-content style=\"fixed-case\">LFT<\/jats:styled-content>s, at median 18\u2010month follow\u2010up, with two patients undergoing regular stent changes, and the remainder requiring no further intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">PB<\/jats:styled-content> can be managed successfully with endoscopic therapy as the first\u2010line option, but a multidisciplinary approach is necessary, with second\u2010line surgical intervention often required. We recommend a management algorithm similar to that presented in the <jats:styled-content style=\"fixed-case\">UK PB<\/jats:styled-content> literature, and confirm that bilioenteric anastomosis can be performed successfully without prior portal decompression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.12436","type":"journal-article","created":{"date-parts":[[2013,11,18]],"date-time":"2013-11-18T12:20:03Z","timestamp":1384777203000},"page":"561-566","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Portal biliopathy: multidisciplinary management and outcomes of treatment"],"prefix":"10.1111","volume":"85","author":[{"given":"Philip Peter","family":"Cellich","sequence":"first","affiliation":[{"name":"Sydney Medical School The University of Sydney  Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Crawford","sequence":"additional","affiliation":[{"name":"Australian National Liver Transplantation Unit Royal Prince Alfred Hospital  Sydney NSW Australia"},{"name":"Department of Upper Gastrointestinal and Hepatobiliary Surgery Royal Prince Alfred Hospital  Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur John","family":"Kaffes","sequence":"additional","affiliation":[{"name":"AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital  Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charbel","family":"Sandroussi","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal and Hepatobiliary Surgery Royal Prince Alfred Hospital  Sydney NSW Australia"},{"name":"Surgical Outcomes Research Centre (SOuRCe) The University of Sydney  Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,11,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.103606"},{"key":"e_1_2_6_3_1","first-page":"520","article-title":"A clinical syndrome associated with a rare anomaly of the vena portae system","volume":"78","author":"Fraser J","year":"1944","journal-title":"Surg. 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