Multiple intrahepatic biliary cysts in children with biliary atresia
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Published on: February 28, 2025
Ling-Nan Bu1, Huey-Ling Chen, Yen-Hsuan Ni
1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Insights
Multiple intrahepatic biliary cysts are a common complication in patients with biliary atresia, indicating a poorer prognosis. Antibiotic treatment is recommended for biliary infection signs.
Area of Science:
- Hepatology
- Pediatric Surgery
- Gastroenterology
Background:
- Biliary atresia is a serious neonatal liver disease.
- Intrahepatic biliary cysts can be a complication.
- Understanding their incidence and impact is crucial.
Purpose of the Study:
- To determine the incidence of intrahepatic biliary cysts in biliary atresia patients.
- To analyze the clinical course and outcomes of these cysts.
- To investigate the specific characteristics of multiple intrahepatic cysts.
Main Methods:
- A cohort of 154 biliary atresia patients were studied between 1992 and 2000.
- Abdominal ultrasonography was used for routine examination and follow-up.
- Clinical data, including jaundice and cholangitis history, were recorded.
Main Results:
- The overall incidence of intrahepatic cysts was 25.3%, with multiple cysts found in 10.4% of patients.
- Patients with multiple cysts frequently presented with jaundice (81.3%) and a history of cholangitis (93.8%).
- Multiple cysts were associated with a higher mortality rate compared to single cysts (P=.037).
Conclusions:
- Multiple intrahepatic biliary cysts are a significant complication in biliary atresia.
- Their presence suggests a poorer prognosis for affected patients.
- Prolonged parenteral antibiotic therapy is advised for biliary infection.
Purpose:
The aim of this study was to investigate the incidence, clinical course, and outcome of multiple intrahepatic biliary cysts in patients with biliary atresia.
Methods:
From 1992 to 2000, 154 patients with biliary atresia were examined for intrahepatic cysts. They were followed and examined routinely using abdominal ultrasonography.
Results:
Twenty-three patients had single intrahepatic cysts, and 16 patients had multiple cysts. The incidence of intrahepatic cysts in these patients were 25.3% (39 of 154) for all kinds of cysts and 10.4% (16 of 154) for multiple intrahepatic cysts. Of the 16 patients with multiple cysts, 13 (81.3%) had jaundice, and 15 (93.8%) had a history of cholangitis before cysts were detected. Image studies showed multiple discrete ovoid or round intrahepatic biliary cysts with various sizes along the biliary trees. The cysts decreased in size or number in 7 patients after antibiotic treatment and disappeared in only one patient. The mortality rate was higher in patients with multiple cysts than in those with single cysts (P =.037).
Conclusions:
Multiple intrahepatic biliary cysts are a common complication in patients with biliary atresia and suggests a poor prognosis. Prolonged parenteral antibiotics treatment should be administered when signs of biliary infection appear.
