| Revue: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000413466 |
| ISSN: | 1665-2681 |
| Autores: | Czubkowski, Piotr1 Cielecka Kuszyk, Joanna2 Rurarz, Malgorzata1 Kaminska, Diana1 Markiewicz Kijewska, Malgorzata3 Pawlowska, Joanna1 |
| Instituciones: | 1The Children’s Memorial Health Institute, Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, Varsovia. Polonia 2The Children’s Memorial Health Institute, Department of Pathology, Varsovia. Polonia 3The Children’s Memorial Health Institute, Department of Pediatric Surgery and Transplantation, Varsovia. Polonia |
| Año: | 2015 |
| Periodo: | Nov-Dic |
| Volumen: | 14 |
| Número: | 6 |
| Paginación: | 902-909 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | The aim of the study was to determine the prognostic value of histopathological findings with special care to the severity of liver fibrosis at the moment of hepatoportoenterostomy (HPE) in children with biliary atresia (BA). We performed analysis of 142 wedge liver biopsies taken at the time of HPE. All patients were operated by the same surgical team between 1995 and 2007. According to the outcome 6 months after HPE patients were divided into prognostic groups: group 1-bilirubin level < 2 mg% (n = 65), group 2-bilirubin level > 2 mg% (n = 77). Liver biopsies were re-evaluated according to the extended histopathological protocol and then were compared between the prognostic groups. Survival with native liver (SNL) estimates were performed in regard to severity of liver fibrosis. Results. Survival with native liver estimates after 2, 5 and 10 years in patients after successful operation were 96%, 91%, 75% vs. 30%, 11%, and 5% if operation failed (p < 0.001). There was no difference between groups in the following variables: fibrosis (p = 0.69), portal inflammation (p = 0.99), lobular inflammation (p = 0.95), cholangiolitis (p = 0.23), accumulation of bile pigments (zone 1:p = 0.49; zone 2:p = 0.51; zone 3:p = 0.48), bile plugs in canaliculi (p = 0.12), bile plugs in ducts (p = 0.32), bilirubinostasis in hepatocytes (p = 0.45), bile ductular proliferation (p = 0.59), ductal plate malformation (p = 0.12), focal necrosis (p = 0.44), giant cell transformation (p = 0.45), haematopoesis (p = 0.52), ductopenia (p = 0.46), microabscesses (p = 0.49), ballooning of hepatocytes (p = 0.08). The actuarial 5/10-year SNL was not dependent on severity of liver fibrosis (log-rank test p = 0.84). The severity of fibrosis corresponded neither with the age at HPE nor with the laboratory findings before operation but increased the risk of portal hypertension. Conclusion. Liver histology at the time of HPE is of limited value in prognosis making in BA |
| Disciplinas: | Medicina |
| Palabras clave: | Diagnóstico, Gastroenterología, Atresia biliar, Hipertensión portal, Biopsia, Valor pronóstico, Trasplante de hígado |
| Keyword: | Medicine, Diagnosis, Gastroenterology, Biliary atresia, Portal hypertension, Biopsy, Prognostic value, Liver transplantation |
| Texte intégral: | Texto completo (Ver PDF) |
