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
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DOI：
10.1016/j.jpedsurg.2007.10.023
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发表时间：
2008-02-01
影响因子：
2.4
通讯作者：
Higuchi, Koji
中科院分区：
文献类型：
--
作者：
Shimadera, Shinichi;Iwai, Naomi;Higuchi, Koji
目的：胆管板畸形（Ductal plate malformation，DPT）是胆道闭锁（biliary atresia，BA）的病因之一。在这项研究中，我们调查的意义，在BA的术后临床过程中，尤其是作为一个预测因素的黄疸clearance.Methods：在1988年和2005年之间，31例无法纠正BA进行肝门肠吻合术和类固醇治疗。免疫组织化学被用来表征使用细胞角蛋白19的胆道结构。如果检测到同心细胞排列，则将标本定义为DPM阳性。这项回顾性研究包括术前特征，术后黄疸期，和累积类固醇剂量之间的患者和无abstraction.Results的比较：31例无法纠正BA，25（80.6%）成为无黄疸。31例中11例（35.5%）发现导管板畸形。两组之间，术前特征或术后无黄疸率无差异。在无黄疸的患者中，术后黄疸期在DPM阳性组（n = 9）为145.3 ± 69.9天，在DPM阴性组（n = 16）为81.8 ± 44.7天（P
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