title: Clinical characteristics of liver fibrosis in patients with choledochal cysts.
abstract: OBJECTIVE
  The aim of the study was to identify the clinical characteristics and outcome of patients with liver fibrosis in choledochal cyst (CC).
  
  
  METHODS
  Forty patients with CC who underwent liver biopsy were included. Liver fibrosis was classified as follows: grade 0, no fibrosis; grade 1, mild fibrosis localized in the portal area; grade 2, moderate fibrosis with occasional bridging; and grade 3, severe fibrosis with diffuse bridging.
  
  
  RESULTS
  Fourteen patients (35%) had liver fibrosis. Patients in the fibrosis group were significantly younger (1.2 vs 2.7 years) and had higher total bilirubin (5.3 vs 2.6 mg/dL). Severity of liver fibrosis was inversely correlated with age (P = .044). Amylase and lipase in bile were significantly lower in the fibrosis group (amylase, 531 vs 15,000 U/L; lipase, 783 vs 23,100 U/L). Postoperative serum analysis demonstrated no differences between the two groups. Most patients in both groups had normal aspartate aminotransferase, alanine aminotransferase, total bilirubin, and γ-glutamyl transpeptidase regardless of severity of fibrosis. Postoperative biliary complication or cholangiocarcinoma was not found in the fibrosis group.
  
  
  CONCLUSIONS
  Our data suggest that liver fibrosis is mainly influenced by obstructive cholangiopathy rather than refluxed pancreatic secretion. Prognosis of patients with CC and liver fibrosis was as good as that of patients without fibrosis.
authors.affiliation: Department of Pediatric Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan. jfujishi@md.tsukuba.ac.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Fujishiro
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Urita
authors.forename: Toko
authors.initials: T
authors.lastname: Shinkai
authors.forename: Chikashi
authors.initials: C
authors.lastname: Gotoh
authors.forename: Noriko
authors.initials: N
authors.lastname: Hoshino
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ono
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Komuro
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000410:Alanine Transaminase / Q000097:blood; D000681:Amylases / Q000032:analysis; D001219:Aspartate Aminotransferases / Q000097:blood; D001646:Bile / Q000201:enzymology; D001706:Biopsy; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000209:etiology; D007223:Infant; D008049:Lipase / Q000032:analysis; D008103:Liver Cirrhosis / Q000097:blood / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D010189:Pancreatic Juice / Q000201:enzymology; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D008049:Lipase; D000681:Amylases