Gallbadder varices

Abstract

Introduction: Gallbladder varices (GBV) are relatively rare ectopic varices in patients with portal hypertension (PH). The aim of the study is to investigate clinical, imagistic and endoscopic data of patients diagnosed with GBV. Material and Methods: Patients diagnosed with GBV over a period of 10 years were identified from the comprehensive database of our institution. Results: There were seven patients (F-4, M-3) with the mean age of 27.9 ± 5.2 (10 to 51) years. PH was caused by portal vein thrombosis (portal cavernoma): after splenectomy for trauma and hematologic disease (n=4), antithrombin III deficiency (n=2) and protein S deficiency (n=l). At time of presentation GBV (n=6) were associated with bleeding esophageal varices (F3, RCS++-i-, Li+m) managed by endoscopic band ligation MBL-6,10 (Wilson-Cook®, Winston-Salem, NC, SUA) and bleeding duodenal varices managed surgically (n=l). Doppler imaging showed the existence of portal cavernoma and GBV. After complete eradication of esophageal varices no GBV enlargement neither other related complications were noticed. Conclusion: Color Doppler sonography is a valuable noninvasive imaging technique for assessment of portal hemodynamic profile in patients with portal cavernoma as well as a useful technique to detect GBV. Preoperative correct diagnosis of GBV should increase the surgeon’s vigilance during biliary tract surgery in patients with PH in order to avoid hazardous complications.