Histopathologic improvement in biliary cirrhosis after definitive surgery for choledochal cyst

Choledochal cysts in infants and children: experiences over a 20-year period at a single institution

“…Although one case of liver cirrhosis was observed in the present study, the extent to which liver fibrosis complicated other cases in this study was not investigated. Liver cirrhosis can develop from liver fibrosis, the latter arising as a consequence of obstructive jaundice due to a choledochal cyst; however, this series of events is considered to occur only rarely [11,26]. Additionally, choledochal cyst rupture, which is almost exclusively a feature of neonates and infants but is rare in older subjects, growth failure, and cachexia in neglected children were not observed in the present study.…”

Timing of surgery for prenatally diagnosed asymptomatic choledochal cysts: a prospective randomized study

“…The complications of pancytopenia associated with splenomegaly, massive ascites, hypoalbuminemia, and coagulation abnormality did not disappear until 4 months after operation. Normalization of liver function test results and amelioration of hepatic fibrosis (shown on needle liver biopsy) did not happen until 1 year postoperatively [12]. Furthermore, long-term studies demonstrated that 16.7% (2/12) of CDC infants died because of delayed surgery and hepatic cirrhosis in a 17-year follow-up study from Taiwan [13].…”

Clinical characteristics of liver fibrosis in patients with choledochal cysts

“…Histologically proven postoperative reversal or improvement of liver fibrosis has been described in some studies [9,10]. Even liver cirrhosis, which was generally considered an irreversible phenomenon, improved after operation in pediatric patients with CC [5,6]. A definitive operation with total cyst excision and reconstruction can remove several causes of liver fibrosis including biliary obstruction, reflux of pancreatic secretions, and subsequent inflammation and infection of the biliary tree, and this would result in the reversal of liver fibrosis.…”

“…operative reversal of cirrhosis has been reported in some cases [5,6]. In this study, we compared the characteristics at presentation, types, and postoperative complications of patients with liver fibrosis and those without liver fibrosis.…”