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Predicting variceal bleeding in patients with biliary atresia

Authors
 Hanbyul Sohn  ;  Sowon Park  ;  Yunkoo Kang  ;  Hong Koh  ;  Seok Joo Han  ;  Seung Kim 
Citation
 SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, Vol.54(11) : 1385-1390, 2019 
Journal Title
 SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY 
ISSN
 0036-5521 
Issue Date
2019
Keywords
Children ; Kasai portoenterostomy ; endoscopy ; transient elastrography
Abstract
Background/aims: Variceal bleeding is the main cause of morbidity and mortality in children with portal hypertension and biliary atresia. The aim of this study is to predict high-risk varices by analyzing various clinical factors, thus improve prognosis of patients with biliary atresia.Methods: A total of 157 patients with biliary atresia who underwent Kasai portoentrostomy were enrolled in a single center. Clinical data including laboratory values, endoscopic findings and values of transient elastography (FibroScan®) were analyzed retrospectively.Results: The bleeding group and the non-bleeding group showed statistically significant differences in several variables; The FibroScan® value (HR 1.05, 95% CI (1.03-1.07), p  <  .01) was higher in the bleeding group. The bleeding group had values of lower albumin after 3 months of operation (HR 0.28, 95% CI (0.11-0.73), p  =  .01), higher bilirubin after 3 months of operation (total bilirubin: HR 1.18, 95% CI (1.04-1.33), p  =  .01), (direct bilirubin: HR 1.21, 95% CI (1.05-1.41), p  =  .01). Gastric varix (HR 4.10, 95% CI (1.62-10.36), p  <  .01) was more frequent in the bleeding group. And the presence of red sign was also predictive of bleeding. The FibroScan® cut-off value with the predictive power of bleeding was 31.5 kPa (HR 7.7, 95% CI (3.36-17.73), p  <  .01).Conclusions: Several clinical factors including high value of transient elastography (FibroScan®), gastric varix or red sign of endoscopy, and low albumin or high bilirubin values after 3 months of Kasai operation can be useful in predicting variceal bleeding in patients with biliary atresia.
Full Text
https://www.tandfonline.com/doi/full/10.1080/00365521.2019.1683225
DOI
10.1080/00365521.2019.1683225
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Yunkoo(강윤구) ORCID logo https://orcid.org/0000-0003-1712-2138
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Kim, Seung(김승) ORCID logo https://orcid.org/0000-0003-4373-9828
Park, So Won(박소원) ORCID logo https://orcid.org/0000-0002-2498-8004
Han, Seok Joo(한석주) ORCID logo https://orcid.org/0000-0001-5224-1437
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174616
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