Biliary system abnormalities in cirrhotic patients have been reported in some radiologic studies, but most of the patients are asymptomatic. The modality of choice to diagnose portal biliopathy in these patients is magnetic resonance cholangiopancreatography (MRCP). In this study, we aimed to assess the prevalence of portal biliopathy and in its relationship with disease severity in cirrhotic patients.

This cross-sectional study was performed on 103 cirrhotic patients who referred to Gastroenterology ward of Ghaem hospital in Mashhad during the one-year study period and consented to participate in the study. Demographic and clinical data were extracted from patients’ files to determine disease severity using Child-Turcotte-Pugh (CTP) and model for end-stage liver disease (MELD) criteria. MRCP was performed for all patients and portal biliopathy was reported by an expert radiologist.

Overall, 103 patients with mean age of 58.85±17.90 years were studied, of whom 67 (65%) were men. The prevalence of portal biliopathies in the population was 14.6% and 86.7% of those were dilative abnormalities. Cryptogenic cirrhosis was the most common cause of disease (73.3%). Right and left intrahepatic ducts were the most common sites of involvement (86.7%). The presence and type of portal biliopathy was not significantly related with disease severity based on CTP criteria. The MELD score had no significant relationship with the presence and type of portal biliopathy. Serum ALP level was significantly associated with presence and type of portal biliopathy, MELD score and CTP class (P<0.05). Platelet count was also significantly associated with the presence of portal biliopathy (P=0.032). MELD score was significantly correlated with ALP and platelet count (P<0.05).

Our results revealed a prevalence of 14.6% for portal biliopathies in cirrhotic patients, most of which were dilative abnormalities. ALP was significantly associated with portal biliopathy and cirrhosis severity and therefore can be a potential prognostic and diagnostic marker..