<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p>A prospective study was undertaken to evaluate the changes in portal venous pressure in patients with
benign biliary obstruction (BBO) but without overt clinical, endoscopic or radiological evidence of portal
hypertension. Portal venous pressure was measured at laparotomy in 20 patients (10 each with either
benign biliary stricture or choledocholithiasis) before and after biliary decompression. Pressure was found
to be on the high side in seven patients (&gt;25 cm of saline in three patients and &gt; 30 cm of saline in four).
The mean fall of pressure was 3.4 cm of saline after biliary decompression. No correlation could, however,
be found between portal venous pressure and duration of biliary obstruction, serum bilirubin or bile duct
pressure. Liver histology showed mild to moderate cholestatic changes but maintained portal architecture
in all. Benign biliary obstruction may therefore, lead to elevation of portal pressure, even though the
patient may not necessarily have any clinical, endoscopic or radiological manifestations of portal hypertension.
The pathogenesis of this ‘latent’ portal hypertension is probably multifactorial. If biliary obstruction
is left untreated the development of overt portal hypertension may become a possibility in the future.</p>
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HPB Surg. 1996; 9(3):149-152