How can portal vein cavernous transformation cause chronic incomplete biliary obstruction?

Table 1 Cholelithiasis and important findings from selected studies

Author	Patient population	Frequency and location of cholelithiasis (%)	Notes
Bayraktar et al[1]	47 PVT patients evaluated by ERCP	8 (19) located in CBD	Unselected PVCT patients irrespective of symptoms, had a control group of 22 patients with other causes of portal hypertension
Condat et al[11]	25 consecutive patients in 2 yr evaluated by MRCP	4 (16)	Cholelithiasis associated with abrupt elevation of transaminase level, obstructive jaundice and cholangitis (2 patients)
Khare et al[27]	13 patients with obstructive jaundice evaluated by ultrasound	4 (31) located in GB, 4 (31) located in CBD	Retrospective selection of patients with obstructive jaundice
Sezgin et al[19]	10 consecutive patients in 6 yr presenting with jaundice and/or cholangitis evaluated by ERCP	0	Only patients with biliary symptoms are evaluated; Total number of patients or prevalence of cholelithiasis is not mentioned
Oo et al[16]	13 patients with symptoms related to PD in 13 yr	11 (84) located in GB, 9 (69) located both in GB and CBD	Symptomatic patients selected
Dumortier et al[28]	6 consecutive patients presented as case series	4 (66) located in GB, 2 also had stones in CBD	Upon follow up 3 patients suffered from cholecystitis and cholangitis requiring cholecystectomy
Chaudhary et al[20]	9 symptomatic PD patients managed surgically	2 (22) located in CBD	Selected patients with indications for surgery; Bile aspirates during surgery revealed Escherichia coli in patients with stones
Agarwal et al[29]	39 symptomatic PD patients managed surgically	12 (30) located in GB, 7 (18) located in CBD	Selected patients with indications for surgery
Dhiman et al[17]	53 symptomatic and asymptomatic patients	11 (20) (7 located in GB while 4 in CBD)	Stones were found more frequently in patients with symptoms than asymptomatic patients
Ozkavukcu et al[30]	16 patients diagnosed with PVT evaluated by MRCP	0 (there are 3 patients with history of cholecystectomy but the reasons are not given)	Patients with history of, chronic liver diseases, liver abcess and hydatid cyst were not eliminated with potential interference with findings of biliary system
Chiu et al[31]	29 children with PVT diagnosis evaluated for Rex shunt	5 (17) located in GB, 4 (14) had biliary sludge	Only children evaluated for possible surgery included
Yamada et al[32]	21 children with PVT	3 (14) located in GB	21 patients selected out of 35, selection criteria not mentioned

PVT: Portal vein transformation; ERCP: Endoscopic retrograde cholangiopancreatography; MRCP: Magnetic resonance cholangiopancreatography; PD: Portal ductopathy; CBD: Common bile duct; GB: Gallbladder; PVCT: Portal vein cavernomatous transformation.