title: Correlations of portal pressure in post-cholecystectomy benign biliary stricture.
abstract: OBJECTIVE
  Presence of portal hypertension (PH) adversely affects perioperative and long-term outcome in patients with post-cholecystectomy benign biliary stricture (PCBBS). Identification of factors related to the development of PH will help to prevent this complication.
  
  
  METHODS
  From September 2010 to December 2012, 30 patients with PCBBS were studied prospectively for correlation of portal pressure (PP) with injury repair interval (IRI), biliary pressure (BP), severity of hepatic fibrosis (FS), severity of hepatic inflammation (IS) and obstructive biliary pathology score (OBPS). Appropriate statistical methods employed and P ≤ 0.05 (two-sided) was considered statistically significant.
  
  
  RESULTS
  Mean PP, mean BP and median IRI were 19.4 ± 4.74 mmHg, 20.1 ± 3.99 mmHg and 145 days, respectively. Spearman's rank correlation coefficients (P-value) of PP with IRI, FS, IS and OBPS were 0.564 (0.001), 0.502 (0.004), 0.752 (0.0001) and 0.242 (0.19), respectively. Pearson correlation of PP with BP was r = 0.383 (r(2)  = 0.146, P = 0.03). Spearman's rank correlation coefficients (P-value) of FS with IS and OBPS were 0.561 (0.003) and 0.371 (0.04), respectively. Spearman's rank correlation coefficient of serum bilirubin with OBPS was 0.550 (P = 0.001). Incidence of PH was 33.3% and mean fall of PP following biliary repair was 6.2 ± 1.98 mmHg (P < 0.0001).
  
  
  CONCLUSIONS
  PP in patients with PCBBS has a good correlation with IS, and a fair correlation with both FS and IRI whereas PP was not directly related to BP and OBPS; further prospective trials are mandatory to confirm this correlation, and to evaluate mechanism of fall in PP following biliary decompression.
authors.affiliation: Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital and M A M College, Delhi University, New Delhi, India.
authors.forename: Hirdaya H
authors.identifier: http://orcid.org/0000-0002-0194-7752
authors.initials: HH
authors.lastname: Nag
authors.affiliation: Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital and M A M College, Delhi University, New Delhi, India.
authors.forename: Asit
authors.initials: A
authors.lastname: Arora
authors.affiliation: Department of Pathology, Govind Ballabh Pant Hospital and M A M College, Delhi University, New Delhi, India.
authors.forename: Ila
authors.initials: I
authors.lastname: Tyagi
authors.affiliation: Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital and M A M College, Delhi University, New Delhi, India.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Ramaswamy
authors.affiliation: Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital and M A M College, Delhi University, New Delhi, India.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Patil
authors.affiliation: Department of Pathology, Govind Ballabh Pant Hospital and M A M College, Delhi University, New Delhi, India.
authors.forename: Puja
authors.initials: P
authors.lastname: Sakhuja
authors.affiliation: Department of Statistics, Govind Ballabh Pant Hospital and M A M College, Delhi University, New Delhi, India.
authors.forename: Renuka
authors.initials: R
authors.lastname: Saha
authors.affiliation: Department of Gastrointestinal Surgery, Govind Ballabh Pant Hospital and M A M College, Delhi University, New Delhi, India.
authors.forename: Anil K
authors.initials: AK
authors.lastname: Agarwal
keywords: benign biliary stricture; correlation; hepatic fibrosis; portal hypertension; post-cholecystectomy