2019 Volume 55 Issue 6 Pages 1061-1065
Purpose: Several investigators have reported that ductal plate malformation (DPM) in the liver is characteristic of persistent embryonal ductular strictures and the embryonic subtype of biliary atresia (BA). We investigated the relationship between liver fibrosis and DPM in BA.
Methods: Thirty-two BA patients underwent Kasai operation from 1976 to 2017. We compared two groups: Group A had DPM and Group B did not. Biopsies obtained during the initial Kasai procedure were histopathologically analyzed in terms of the degree of portal-portal (P-P) bridging and the existence of portal-central vein (P-C) bridging. The degree of P-P bridging was defined as follows: Grade 1, P-P <50%; Grade 2, >50%; Grade 3, nodular architecture. We also evaluated the age at the time of Kasai operation, the number of patients who became jaundice-free (JF; total bilirubin <2.0 mg/dl), and the time taken to become JF. Statistical comparisons of multiple data were carried out using the chi-square test and Student’s t-test. Regression analysis was carried out with the significance level set at p <0.05.
Results: There were nine patients in Group A and 23 patients in Group B. There was no significant difference in P-P bridging (p = 0.281). Seven patients had P-C bridging in Group A and eight in Group B (p = 0.028). The ages at the time of Kasai operation were 67.3 ± 17.8 days in Group A and 89.0 ± 29.7 days in Group B (p = 0.050). There were no significant differences in the number of JF patients (p = 0.599) and the time taken to become JF (p = 0.252).
Conclusions: DPM tended to be associated with early age of operation and having P-C bridging.
