Evidence map›Paper›PMID 41171449›Full record

ArticlePediatric surgery international2025

Portal hypertension in biliary atresia: a Japanese biliary atresia registry study.

Ryuji Okubo, Masaki Nio, Hideyuki Sasaki, Taichi Fukuzawa, Hironori Kudo, Ryo Ando, Tsuyoshi Sakurai, Masatoshi Hashimoto, Keisuke Tada, Motoshi Wada and 1 more

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In one paragraph

Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
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

11 authors.

Ryuji OkuboDepartment of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Masaki NioDepartment of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Hideyuki SasakiDepartment of Surgery, Miyagi Children's Hospital, 4-3-17, Ochiai, Aoba-ku, Sendai, Miyagi, 989-3126, Japan.
Taichi FukuzawaDepartment of Surgery, Miyagi Children's Hospital, 4-3-17, Ochiai, Aoba-ku, Sendai, Miyagi, 989-3126, Japan.
Hironori KudoDepartment of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Ryo AndoDepartment of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Tsuyoshi SakuraiDepartment of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Masatoshi HashimotoDepartment of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Keisuke TadaDivision of Pediatric Surgery, Department of Surgery II, Faculty of Medicine, Yamagata University, 2-2-2 Iidanishi, Yamagata, 990-9585, Japan.
Motoshi WadaDepartment of Pediatric Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. wada@ped-surg.med.tohoku.ac.jp.
Japanese Biliary Atresia Society

Funding

the MHLW Research on Rare and Intractable Diseases Program JPMH25FC1013
6 · The paper itself

Abstract

purposeThis study aimed to clarify the incidence of portal hypertension (PH) in biliary atresia (BA), its impact on long-term native liver survival rates (NLSRs), and the role of PH treatment.

methodsData were analyzed from 3,777 patients in the Japanese Biliary Atresia Registry (1989-2021). Incidence and treatment of PH were examined in all patients and in 20-year native liver survivors. A subgroup of 596 jaundice-free native liver survivors was divided into three groups: without PH (A), untreated PH (B), and treated PH (C). Patient characteristics, clinical outcomes, and survival analyses were performed.

resultsPH occurred in 46.4% of all patients, with gastroesophageal varices (35.1%) and hypersplenism (36.8%) being most common. Among 759 20-year native liver survivors, 49.8% had PH, largely diagnosed between 2 and 15 years. Group C patients were older at Kasai portoenterostomy and had more cholangitis. Survival analysis showed best outcomes in group A and worst in group C. Conditional native liver survival analysis revealed group B initially had better NLSRs than group C, but differences diminished beyond 15 years.

conclusionIn native liver survivors without jaundice following KP, PH influenced prognosis, but successful treatment enabled long-term survival comparable to patients with mild or no PH.

Indexed as

Biliary AtresiaHypertension, PortalAdolescentChildChild, PreschoolEast Asian PeopleFemaleHumansIncidenceInfantInfant, NewbornJapanMalePortoenterostomy, HepaticRegistriesRetrospective StudiesBiliary atresiaGastroesophageal varicesHypersplenismLong-term follow-upPortal hypertension

Identifiers

PMID41171449
PMCPMC12578773

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LicenceCC BY
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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.