Intrahepatic Cystic Lesions in Children with Biliary Atresia After Kasai Procedure
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In brief
In brief
This retrospective study of 787 biliary atresia patients found a 9.7% incidence of intrahepatic cystic lesions post-Kasai procedure, with 70% experiencing cholangitis. Earlier ICL onset (within 3 months) and cholangitis history significantly reduced 2-year native liver survival rates, suggesting these factors are key prognostic indicators.
Written by the GCMD Library team from the article.
Background
Intrahepatic cystic lesion (ICL) is a common complication for biliary atresia post-Kasai portoenterostomy. The purpose of this study was to review the cases in our hospital and assess the correlation between characteristics of ICL and clinical outcomes.
Methods
We retrospectively analyzed 787 cases of biliary atresia from 2012 to 2016. Demographics, clinical details, and postoperative outcomes were reviewed.
Results
A total of 76 patients were diagnosed with ICLs using ultrasound post-Kasai procedure, and the incidence was 9.7%. Preoperative characteristics showed no significant differences between ICL (+) and ICL (−) groups. Nearly 70% (53/76) of the patients with ICLs had a history of cholangitis. The 2-year native liver survival rate was 60.4% for those with a history of cholangitis and 87% for those without (P = 0.017). Further analysis showed that the 2-year native liver survival rate was 42.9% for those diagnosed within 3 months post-Kasai procedure, 54.2% for those diagnosed between 3 and 6 months, and 80.0% for those diagnosed beyond 6 months (P = 0.002), while no significance was observed for type (P = 0.094) or site (P = 0.406) of ICL.
Conclusion
Patients with ICLs had a high incidence of cholangitis. The prognosis was closely related with the history of cholangitis and the onset time of ICLs.
Level of evidence
Level II.