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Background: The pathogenesis of portal vein thrombosis (PVT) in cirrhosis is multifactorial, with altered hemodynamics being proposed as a possible contributor. The present systematic review was conducted to study the role of assessment of portal hemodynamics for the prediction of PVT in patients with cirrhosis., Methods: Three databases (Medline, Embase, and Scopus) were searched from inception to February 2023 for studies comparing portal venous system parameters in patients with cirrhosis developing PVT with those not. Results were presented as mean difference (MD) or odds ratio (OR) with their 95% confidence intervals (CIs)., Results: A total of 31 studies (patients with cirrhosis: 19 studies, patients with cirrhosis undergoing splenectomy: 12 studies) were included. On pooling the data from multivariable analyses of the included studies, a larger portal vein diameter was a significant predictor of PVT in patients with cirrhosis without or with splenectomy with OR 1.74 (1.12-2.69) and OR 1.55 (1.26-1.92), respectively. On the other hand, a lower portal vein velocity (PVV) was a significant predictor of PVT in cirrhotics without or with splenectomy with OR 0.93 (0.91-0.96) and OR 0.71 (0.61-0.83), respectively. A PVV of <15 cm/s was the most commonly used cut-off for the prediction of PVT. Patients developing PVT also had a significantly higher splenic length, thickness, and splenic vein velocity., Conclusion: The assessment of portal hemodynamic parameters at baseline evaluation in patients with cirrhosis may predict the development of PVT. Further studies are required to determine the optimal cut-offs for various parameters., (© 2023 Wiley Periodicals LLC.)

The dynamics of morphological changes developed in liver and bile ducts in biliary obstruction are well studied in the animal models of biliary obstruction, however,the data on the morphology of the portal tracts are scarce. The aim of the research was to study the structure of the portal tracts and interrelationship of their structural components in experimental biliary obstruction. The investigation was conducted on albino Wistar rats weighing 200-250 g, undergone biliary obstruction by common bile duct ligation (CBDL). The histological, histochemical and immunohistochemical investigation of the liver tissue stained with Hematoxylin& Eosin, Masson's trichrome and marked with CK8antibody were performed on the 3rd, 6th and 12th days after CBDL. The CBDL-induced biliary obstruction triggers a systemic reaction of the bile ducts and a complex of accompanying reactions that is heterogeneous, depending on the caliber of both the bile ducts themselves and the portal tracts containing them.CBDL causes dilation of the large bile ducts, their pressure on the portal veins with the deformation of their lumens, changes in the architectonics of the portal tracts, and expansion of the portal areas accompanied by increasing portal fibrosis and ductular reaction. The small bile ducts are less prone to dilation under CBDL conditions but actively proliferate and penetrate widely into the parenchyma of the liver lobules. Based on this ductal reaction, fibrosis of increasing intensity develops, which connects the adjacent portal tracts as well as the portal tracts and the connective tissue sheaths of the thin tributaries of hepatic veins. In the conditions of such fibrosis, it is difficult to identify the individual portal tracts of small caliber and, moreover, to clarify the relationship between their elements.