Evidence map›Paper›PMID 38032513›Full record

ArticlePediatric surgery international2023

Prospective evaluation of common hepatic duct histopathology at the time of choledochal cyst excision ranging from children to adults.

Koki Nikai, Hiroyuki Koga, Kazuto Suda, Katsumi Miyahara, Geoffrey J Lane, Atsushi Arakawa, Yuki Fukumura, Akio Saiura, Yutaka Hayashi, Yuichi Nagakawa and 4 more

Abstract read
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In one paragraph

Article in Pediatric surgery international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 1 country.

Koki NikaiDepartment of Pediatric Surgery, Juntendo Urayasu Hospital, Chiba, Japan.
Hiroyuki KogaDepartment of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. h-koga@juntendo.ac.jp.
Kazuto SudaDepartment of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Katsumi MiyaharaDepartment of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Geoffrey J LaneDepartment of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Atsushi ArakawaDepartment of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan.
Yuki FukumuraDepartment of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan.
Akio SaiuraDepartment of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Yutaka HayashiDepartment of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
Yuichi NagakawaDepartment of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
Tadaharu OkazakiDepartment of Pediatric Surgery, Juntendo Urayasu Hospital, Chiba, Japan.
Chie TakishitaDepartment of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
Toshihiro YanaiDepartment of Pediatric Surgery, Ibaraki Children's Hospital, Ibaraki, Japan.
Atsuyuki YamatakaDepartment of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Juntendo University · JPTokyo Medical University · JPJuntendo University Urayasu Hospital · JPIbaraki Children's Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate common hepatic duct just distal to the HE anastomosis (d-CHD) prospectively for mucosal damage, inflammation, fibrosis, dysplasia, carcinoma in situ, malignant transformation, effects of serum amylase, and symptoms at presentation in CC cases ranging from children to adults.

methodsCross-sections of d-CHD obtained at cyst excision 2018-2023 from 65 CC patients; 40 children (< 15 years old), 25 adults (≥ 15) were examined with hematoxylin and eosin, Ki-67, S100P, IMP3, p53, and Masson's trichrome to determine an inflammation score (IS), fibrosis score (FS), and damaged mucosa rate (DMR; damaged mucosa expressed as a percentage of the internal circumference).

resultsMean age at cyst excision ("age") was 18.2 years (range: 3 months-74 years). Significant inverse correlations were found for age and DMR (p = 0.002), age and IS (p = 0.011), and age and Ki-67 (p = 0.01). FS did not correlate with age (p = 0.32) despite significantly increased IS in children. Dysplasia was identified in a 4-month-old girl with cystic CC. Serum amylase was elevated in high DMR subjects.

conclusionsHigh DMR, high IS, and evidence of dysplasia in pediatric CC suggest children are at risk for serious sequelae best managed by precise histopathology, protocolized follow-up, and awareness that premalignant histopathology can arise in infancy.

Indexed as

Choledochal CystHepatic Duct, CommonAdolescentAdultAmylasesChildFemaleFibrosisHumansInfantInflammationKi-67 AntigenAmylasesKi-67 AntigenCholedochal cystCommon hepatic ductDamaged mucosa rateMalignancyProspective studySerum amylase level

Identifiers

PMID38032513
OpenAlexW4389180635

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.