Abstract
Biliary atresia (BA) causes biliary obstruction in neonates. Although the Kasai operation can successfully treat certain BA cases, many patients exhibit recurrent jaundice and secondary biliary cirrhosis requiring liver transplantation. Consequently, studies of the prognostic factors of the Kasai operation are needed. Accordingly, sonic hedgehog (SHH) pathway expression at the extrahepatic bile duct (EHBD), an important bile duct repair mechanism, will be investigated via immunohistochemistry in patients with BA to examine the association with post-Kasai operation prognosis. Fifty-seven EHBD specimens were obtained during Kasai operations from 1992 to 2009. The SHH, patched (PTCH), and glioblastoma-2 (Gli-2) immunohistochemical staining results were analyzed quantitatively. Overall, 57.9% of patients had bile flow normalization after the Kasai operation; 43.1% did not. High preoperative serum total bilirubin, direct bilirubin, and aspartate aminotransferase levels were associated with sustained jaundice post-Kasai operation, as was an age ≥65days at the time of surgery (all p<0.05). High Gli-2 and SHH expression rates were significantly associated with early post-Kasai operation jaundice relapse. Strong Gli-2 and SHH expression...Continue Reading
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Citations
Apr 23, 2017·Development·Hiroki HigashiyamaYoshiakira Kanai
Apr 1, 2018·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jorge A BezerraRonald J Sokol
Sep 28, 2018·International Journal of Molecular Sciences·Diletta OveriEugenio Gaudio
Jun 14, 2019·Stem Cells International·Maria P de MiguelM A Aller
Aug 30, 2021·EBioMedicine·Wai-Yee LamPaul Kwong-Hang Tam