Significance of ductal plate malformation in the postoperative clinical course of biliary atresia.

Significance of ductal plate malformation in the postoperative clinical course of biliary atresia. Research Abstract Details 

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Significance of ductal plate malformation in the postoperative clinical course of biliary atresia. Abstract Text:

Shinichi Shimadera,Naomi Iwai,Eiichi Deguchi,Osamu Kimura,Shigeru Ono,Shigehisa Fumino,Koji Higuchi,Shinichi Shimadera,Naomi Iwai,Eiichi Deguchi,Osamu Kimura,Shigeru Ono,Shigehisa Fumino,Koji Higuchi,

PURPOSE: Ductal plate malformation (DPM) is one of the etiologic theories for the development of biliary atresia (BA). In this study, we investigated the significance of DPM in the postoperative clinical course of BA, especially as a predictive factor of jaundice clearance. METHODS: Between 1988 and 2005, 31 patients with uncorrectable BA underwent hepatoportoenterostomy and steroid therapy. Immunohistochemistry was used to characterize biliary structures using cytokeratin 19. Specimens were defined as DPM-positive if a concentric cellular arrangement was detected. This retrospective study included comparisons of preoperative characteristics, the postoperative jaundice period, and cumulative steroid doses between patients with and without DPM. RESULTS: Of the 31 patients with uncorrectable BA, 25 (80.6%) became jaundice-free. Ductal plate malformation was detected in 11 (35.5%) of the 31. Between the 2 groups, there were no differences in preoperative characteristics or in the postoperative jaundice-free rate. Among those who became anicteric, the postoperative jaundice period was 145.3 +/- 69.9 days in the DPM-positive group (n = 9) and 81.8 +/- 44.7 days in the DPM-negative group (n = 16) (P < .05). The total administered steroids were 149.7 +/- 78.2 and 95.0 +/- 60.2 mg/kg, respectively (P = .09). CONCLUSION: Ductal plate malformation may disturb bile flow and require more steroid to improve bile drainage. Therefore, the presence of DPM in the liver predicts poor bile flow after hepatoportoenterostomy in infants with BA.

Significance of ductal plate malformation in the postoperative clinical course of biliary atresia. Publishing Authors By Initials

S Shimadera,N Iwai,E Deguchi,O Kimura,S Ono,S Fumino,K Higuchi,S Shimadera,N Iwai,E Deguchi,O Kimura,S Ono,S Fumino,K Higuchi,

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Significance of ductal plate malformation in the postoperative clinical course of biliary atresia. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Journal of pediatric surgery

VOLUME: 43

Page Numbers: 304-7

Journal Abbreviation: J. Pediatr. Surg.

ISSN: 1531-5037

DAY: 18

MONTH: Feb

YEAR: 2008

Significance of ductal plate malformation in the postoperative clinical course of biliary atresia. Information

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LANGUAGE: eng

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AFFILIATION: Division of Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan. sshima@koto.kpu-m.ac.jp

Country: United States

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MEDLINETA: J Pediatr Surg

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