Endoscopic treatment of portal biliopathy

Abstract Portal biliopathy refers to changes in intra and extrahepatic biliary system in patients with portal hypertension. It is most commonly seen in patients with extra-hepatic portal vein obstruction. Pathogenesis are thought to be either direct compression from peri or epicholedochal varices or from secondary ischemia. Symptoms in the form of pain, fever and jaundice may require treatment. Two stage surgery with shunt followed by biliary bypass has been advocated. Role of Endoscopic retrograde cholangiopancreatography (ERCP) in long term treatment of portal biliopathy has been reported in small case series. This review discusses role of ERCP in long term management of biliary strictures in portal biliopathy.