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Relation between amount of bile ducts in portal canal and outcomes in biliary atresia

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Abstract

Background

There is no good prognostic indicator for biliary atresia (BA). We reviewed liver biopsies taken during the initial procedure to find a prognostic marker.

Methods

Thirty-two BA cases underwent Kasai operation from 1976 to 2009. We compared two groups at 1, 3, and 9 years. Group A required liver transplantation or died. Group B survived with their native liver. Biopsies were analyzed for liver fibrosis, portal-central vein bridging (P–C bridging), ductal plate malformation (DPM) and the number of the bile ducts in portal canal/measured surface area of the portal canal (BDP ratio). Statistical comparisons of the multiple data were evaluated by Mann–Whitney U test, Student’s t test and Pearson’s Chi-square test. Regression analysis with P < 0.05 was considered significant.

Results

BDP ratios (/mm2) were 2.4 ± 1.5 in Group A1 (n = 9) vs 4.6 ± 2.4 in Group B1 (n = 23) (P = 0.01); 2.6 ± 1.4 in Group A3 (n = 14) vs 5.1 ± 2.5 in Group B3 (n = 18) (P < 0.01), 3.0 ± 2.2 in Group A9 (n = 15) vs 4.9 ± 2.5 in Group B9 (n = 15) (P < 0.05). There was no significant difference in any other finding.

Conclusion

The BDP ratio is a sound prognostic indicator in BA.

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Acknowledgments

The authors thank Shigeko Ohnuma and the other staffs in the Department of Pathology in St. Marianna University school of Medicine for assistance in processing the histology.

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Authors and Affiliations

  1. Division of Pediatric Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan

    Juma Obayashi, Kunihide Tanaka, Kei Ohyama, Shutaro Manabe, Hideki Nagae, Hideki Shima, Hideaki Sato, Shigeyuki Furuta, Munechika Wakisaka & Hiroaki Kitagawa

  2. Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan

    Junki Koike & Masayuki Takagi

Authors
  1. Juma Obayashi
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  2. Kunihide Tanaka
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  3. Kei Ohyama
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  4. Shutaro Manabe
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  5. Hideki Nagae
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  6. Hideki Shima
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  7. Hideaki Sato
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  9. Munechika Wakisaka
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  10. Junki Koike
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  11. Masayuki Takagi
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  12. Hiroaki Kitagawa
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Corresponding author

Correspondence to Hiroaki Kitagawa.

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Obayashi, J., Tanaka, K., Ohyama, K. et al. Relation between amount of bile ducts in portal canal and outcomes in biliary atresia. Pediatr Surg Int 32, 833–838 (2016). https://doi.org/10.1007/s00383-016-3941-y

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  • DOI: https://doi.org/10.1007/s00383-016-3941-y

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