Prenatally diagnosed biliary cysts: A spectrum from congenital biliary dilatation to biliary atresia from the same origin

Kato, Shoko; Kaneko, Kenitiro; Matsushita, Nozomi; Saito, Takuya; Fukami, Yasuyuki; Komatsu, Shunichiro; Sano, Tsuyoshi

doi:10.1002/jhbp.1158

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…Complete obstruction of the distal common bile duct is a severe subtype of choledochal cyst characterized by the inability of contrast medium to enter the duodenum through the common bile duct, and few clinical studies have reported this subtype [ 19 – 21 ]. Our findings revealed higher serum MMP-7 in the complete obstruction group compared to the incomplete obstruction group of CDCs.…”

Section: Discussionmentioning

confidence: 99%

Relationships of serum MMP-7 and clinical characteristics in choledochal cyst children

Yin,

Chen,

Zhou

et al. 2024

BMC Surg

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Background Matrix metalloproteinase-7 (MMP-7) is associated with biliary injury. This study aimed to evaluate the relationships of serum MMP-7 with clinical characteristics in choledochal cysts (CDC) children. Methods Between June 2020 and July 2022, we conducted a prospective study of CDCs who underwent one-stage definitive operation at our center. Serum MMP-7 was measured using an enzyme-linked immunosorbent assay. We evaluated the relationships between serum MMP-7 and age, laboratory tests, imaging examinations, liver fibrosis, MMP-7 expression, and perforation. Results A total of 328 CDCs were enrolled in the study, with a median serum MMP-7 of 7.67 ng/mL. Higher serum MMP-7 was correlated with younger age at diagnosis (p < 0.001), larger cyst sizes (p < 0.001), higher liver fibrosis stages (p < 0.001), and higher incidence of perforation (p < 0.01). Liver MMP-7 was mainly expressed in intrahepatic and extrahepatic biliary epithelial cells. The area under the receiver operating characteristic curve (AUROC) was 0.630 (p < 0.001) for serum MMP-7 in predicting perforation. When serum MMP-7 was combined with γ-glutamyl transferase (GGT), the AUROC increased to 0.706 (p < 0.001). Conclusions Serum MMP-7 was associated with biliary obstruction in CDCs. Patients with high serum MMP-7 were more likely to have severe liver damage and biliary injury, with higher incidences of liver fibrosis and perforation.

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Section: Discussionmentioning

confidence: 99%

Relationships of serum MMP-7 and clinical characteristics in choledochal cyst children

Yin,

Chen,

Zhou

et al. 2024

BMC Surg

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Fetal hepatobiliary cysts: clinical spectrum and differential diagnosis

Sun,

Xiu,

et al. 2024

American Journal of Obstetrics & Gynecology MFM

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A case series of prenatal hepatic hilar cyst in the presence of a gallbladder - navigating the dilemma between biliary atresia and choledochal cyst

Calinescu,

Rougemont,

McLin

et al. 2024

BMC Pediatr

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Background Prenatally diagnosed hepatic hilar cysts are a challenging finding for the clinician. They can either be a sign of cystic biliary atresia (BA) or a choledochal cyst (CC), two diagnoses with different postnatal management and prognosis. Based on a case report of four patients, we aim to propose a management algorithm for prenatally diagnosed “hepatic hilar cysts”. Case presentation A hepatic hilar cyst, ranging from 5 to 25 mm, was detected prenatally in all four girls confirmed postnatally along with the presence of a gallbladder. Stool color was normal until two weeks of life at which time the stool color became lighter, and the patients developed cholestasis. All were operated before seven weeks of life: Case 1 had a CC with patent but irregular intrahepatic bile ducts at intraoperative cholangiogram, and no communication with the duodenum. A Roux-en-Y bilioenteric anastomosis was performed. The cyst showed complete epithelial lining loss, and liver pathology showed BA features. Case 2 had the final diagnosis of cystic BA with patent but abnormal intrahepatic bile ducts. She underwent two operations: the first operation at four weeks as described for case 1, since intraoperative findings were similar, as was histology. As cholestasis increased postoperatively, she underwent a Kasai hepato-porto-enterostomy six weeks later, where distinct BA findings were found with complete scarring of the hilar plate. Case 3 had a cystic BA with the cyst located within the common bile duct and atretic bile ducts proximal to the porta hepatis. It exhibited no communication with the liver or duodenum. A Kasai operation was performed, with histology showing complete epithelial loss within the cyst wall and scarring of the hilar plate. Case 4 had a cystic BA presenting a completely obliterated hepatic duct with the cyst lying within the common bile duct. A Kasai procedure was performed. Histology showed a common bile duct with a residual lumen of 0.1 mm. Conclusions The spectrum of disease from CC to BA in the setting of a prenatally discovered hepatic hilar cyst is emphasized. Even if cholangiogram differentiates most patients with BA from those with CC, caution is advised for transitional types.

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Prenatally diagnosed biliary cysts: A spectrum from congenital biliary dilatation to biliary atresia from the same origin

Cited by 3 publications

References 7 publications

Relationships of serum MMP-7 and clinical characteristics in choledochal cyst children

Relationships of serum MMP-7 and clinical characteristics in choledochal cyst children

Fetal hepatobiliary cysts: clinical spectrum and differential diagnosis

A case series of prenatal hepatic hilar cyst in the presence of a gallbladder - navigating the dilemma between biliary atresia and choledochal cyst

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