A Study of Histopathological Profile of Liver in Paediatric Choledochal Cysts

医学 胆总管囊肿 黄疸 吻合 活检 肝活检 组织学 纤维化 放射科 胃肠病学 外科 内科学 囊肿
作者
G. J. Vani Padmaja,Othuluru Radhika Krishna,Seereen Siddiqa,Mandakini Kotaiah Srinivas Reddy,K. Venugopal Reddy
出处
期刊:Journal of Evidence Based Medicine and Healthcare [Level Up Business Center]
卷期号:7 (50): 3055-3060
标识
DOI:10.18410/jebmh/2020/623
摘要

BACKGROUND Choledochal cysts are rare congenital dilatations of the biliary tract with an incidence of approximately 1 in 1000 live births. Most cases present with jaundice or other obstructive symptoms and are treated by surgical resection of the cyst and re-anastomosis. A liver biopsy at the time of surgery is mandatory to study the histological changes including fibrosis and to grade these changes to determine prognosis. We wanted to study the histology of liver biopsies received along with choledochal cysts, grade the hepatocellular damage and fibrosis, and correlate these findings with clinical presentation of the patients. METHODS 40 liver biopsies received along with choledochal cysts in paediatric patients were assessed for histological changes using 7 parameters including liver fibrosis and scored semi-quantitatively according to established scoring systems. These scores were correlated with the clinical data, age at surgery, sex of the patient, type of choledochal cyst, clinical features, and the results were analysed for their role in predicting patient prognosis. RESULTS We found that all the cases showed histological variations in the liver biopsy. Age of children showed an inverse relationship with histological scoring. Infants showed higher scores in comparison to older children. Fibrosis of the liver was also higher in Infants. Most of the cases presented with clinical jaundice. Patients with jaundice, pain abdomen, fever and acholic stools showed higher scores. We found that the sex of the patient and type of choledochal cysts were independent of the scores. CONCLUSIONS Younger age and more severe clinical presentation warrant an urgent surgical intervention in paediatric choledochal cyst. Histological assessment of the liver is mandatory to grade the hepatocellular changes including fibrosis and suggest prognosis and follow up of patients. KEYWORDS Liver Histology, Grading, Paediatric Choledochal Cyst

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