1464例小儿先天性胆道扩张患者肝右动脉解剖变异对胆道梗阻及肝纤维化的影响

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-06-05 DOI:10.1002/jhbp.12171

Jianfeng Luo, Kaikun Huang, Anxiao Ming, Haibin Wang, Yu Tian, Mei Diao, Long Li

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引用次数: 0

摘要

背景：腹侧肝右动脉（RHA）在先天性胆道扩张（CBD）中的作用尚不清楚。方法：我们回顾性分析了2015年至2023年接受手术的1464例小儿CBD患者，比较了腹侧定位RHA和正常RHA。结果：10.31%的患者发现腹侧RHA，并伴有更频繁的症状（如腹痛、呕吐、黄疸）、肝酶升高和更高的肝纤维化发生率（23.40%对14.85%,p = 0.008）。它是纤维化的独立危险因素（校正OR = 1.74, p = 0.011），与胆管狭窄和肝内管扩张增加相关。中位随访41个月未见复发。结论：腹侧定位RHA可导致小儿CBD患者胆道梗阻和肝纤维化。早期识别和手术矫正可以改善预后并减少长期并发症。

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Impact of Anatomical Variations of Right Hepatic Artery on Biliary Obstruction and Liver Fibrosis in Pediatric Congenital Biliary Dilatation Patients: A Retrospective Analysis of 1464 Cases.

Background: The role of the ventrally positioned right hepatic artery (RHA) in congenital biliary dilatation (CBD) remains unclear.

Methods: We retrospectively analyzed 1464 pediatric CBD patients undergoing surgery from 2015 to 2023, comparing those with ventrally positioned versus normal RHA.

Results: Ventrally positioned RHA was identified in 10.31% of patients and was associated with more frequent symptoms (e.g., abdominal pain, vomiting, jaundice), elevated liver enzymes, and a higher incidence of liver fibrosis (23.40% vs. 14.85%, p = 0.008). It was an independent risk factor for fibrosis (adjusted OR = 1.74, p = 0.011) and correlated with increased bile duct strictures and intrahepatic duct dilation. No recurrence was observed during a 41-month median follow-up.

Conclusions: Ventrally positioned RHA contributes to biliary obstruction and liver fibrosis in pediatric CBD. Early recognition and surgical correction may improve outcomes and reduce long-term complications.

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.