title: The clinical significance of intrahepatic cystic lesions in postoperative patients with biliary atresia.
abstract: OBJECTIVE
  To clarify the significance of intrahepatic cystic lesions (ICLs) after Kasai procedure for biliary atresia (BA), we reviewed the BA patients with special reference to the shape of ICLs.
  
  
  METHODS
  For the last two decades, 75 cases have been followed up at our institution. The patients were divided into two groups: ICLs (+) with ICL and ICLs (-) without ICL. Seventeen cases of ICLs (+) were divided into two categories: the round type and the multiple-bead type. A poor prognosis was defined as mortality or the need for liver transplantation (LT).
  
  
  RESULTS
  The ratio of round to multiple-bead types was 6:11. The percentage of poor prognoses with ICLs (+) and ICLs (-) was 47 and 53 %, respectively. The percentage of poor prognoses with round and multiple-bead types was 27 and 83 %, respectively (p < 0.05). In cases of ICLs (+), an LT was required because of hepatic deterioration in all three of the round types, and intractable cholangitis in all five of the multiple-bead types (p < 0.05).
  
  
  CONCLUSIONS
  The long-term prognosis of BAs after the Kasai procedure does not necessarily depend on the development of ICLs per se, but on their shape.
authors.affiliation: Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan. tgoda@mch.pref.osaka.jp
authors.forename: Taro
authors.initials: T
authors.lastname: Goda
authors.forename: Akio
authors.initials: A
authors.lastname: Kubota
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Kawahara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yoneda
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tazuke
authors.forename: Gakuto
authors.initials: G
authors.lastname: Tani
authors.forename: Kengo
authors.initials: K
authors.lastname: Nakahata
mesh_terms: D001656:Biliary Atresia / Q000601:surgery*; D003560:Cysts / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D016031:Liver Transplantation; D011171:Portoenterostomy, Hepatic / Q000009:adverse effects*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography