title: Intraductal ultrasonographic anatomy of biliary varices in patients with portal hypertension.
abstract: OBJECTIVE
  The term, portal biliopathy, denotes various biliary abnormalities, such as stenosis and/or dilatation of the bile duct, in patients with portal hypertension. These vascular abnormalities sometimes bring on an obstructive jaundice, but they are not clear which vessels participated in obstructive jaundice. The aim of present study was clear the bile ductal changes in patients with portal hypertension in hopes of establishing a therapeutic strategy for obstructive jaundice caused by biliary varices.
  
  
  METHODS
  Three hundred and thirty-seven patients who underwent intraductal ultrasound (IDUS) during endoscopic retrograde cholangiography for biliary abnormalities were enrolled. Portal biliopathy was analyzed using IDUS.
  
  
  RESULTS
  Biliary varices were identified in 11 (2.7%) patients. IDUS revealed biliary varices as multiple, hypoechoic features surrounding the bile duct wall. These varices could be categorized into one of two groups according to their location in the sectional image of bile duct: epicholedochal and paracholedochal. Epicholedochal varices were identified in all patients, but paracholedochal varices were observed only in patients with extrahepatic portal obstruction.
  
  
  CONCLUSIONS
  IDUS was useful to characterize the anatomy of portal biliopathy in detail.
authors: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors: Tadayuki
authors: T
authors: Takagi
authors: Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Japan.
authors: Atsushi
authors: A
authors: Irisawa
authors: Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Japan.
authors: Goro
authors: G
authors: Shibukawa
authors: Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan.
authors: Takuto
authors: T
authors: Hikichi
authors: Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan.
authors: Katsutoshi
authors: K
authors: Obara
authors: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors: Hiromasa
authors: H
authors: Ohira
keywords: Biliary varices; intraductal ultrasound; portal biliopathy; portal hypertension