The impact of pathological cyst wall changes on congenital biliary dilatation in infancy.
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PURPOSE: This study aimed to evaluate the impact of pathological changes in bile duct cysts on the clinical and liver pathological findings in early infantile patients with congenital biliary dilatation (CBD). METHOD: In patients with CBD who underwent definitive surgery ≤ 4 months of age, the clinical and liver pathological findings were analyzed according to the presence or absence of inflammatory and fibrotic changes on the luminal side of the bile duct cyst. RESULTS: Among the 14 patients with infantile CBD, 8 had inflammatory cell infiltration (iCBD), and 4 of these 8 patients showed the formation of a collagen layer together. In the remaining six patients, no infiltration of inflammatory cells or formation of collagen layers was observed (non-iCBD). In the iCBD group, the preoperative liver biochemistry levels were higher, the cyst amylase levels were lower, and the degree of liver fibrosis was more severe than those in the non-iCBD group, with significant differences. In comparisons of iCBD patients, there were no differences in the preoperative liver biochemistry levels, cyst amylase levels, and severity of liver fibrosis between the presence and absence of a collagen layer. CONCLUSION: Inflammatory and fibrotic changes in the bile duct cysts due to obstructive cholestasis may affect the clinical and liver histopathological differences in early infantile CBD after birth.