WOFAPS 2025 8th World Congress of Pediatric Surgery

Gökay Gökdeniz ¹, Önder Özden ¹, Recep Tuncer ¹, Şeref Selçuk Kılıç ¹, Selcan Türker Çolak ¹, Kamuran Tutuş ¹, Kıvılcım Eren Ateş ²

¹ Cukurova University Faculty of Medicine Department of Pediatric Surgery
² Cukurova University Faculty of Medicine Department of Pathology

Purpose:
Ductal plate malformation (DPM) is a histopathological feature believed to worsen prognosis in biliary atresia (BA). This study aimed to determine whether DPM specifically predicts the clearance of jaundice after portoenterostomy.

Materials and Methods:
We retrospectively reviewed patients who underwent portoenterostomy for BA from 2007 to 2023. Liver biopsies were examined for DPM by an expert pathologist blinded to outcomes. Patients were categorized as DPM (+) or DPM (–). The primary outcome was clearance of jaundice(serum total bilirubin <2 mg/dL within 6 months after surgery). Secondary outcomes included native liver survival. Statistical analysis involved Chi-square/Fisher’s Exact tests and Kaplan-Meier methods.

Results:
Among 56 patients, DPM was present in 37.5% (n=21). Clearance of jaundice was numerically lower in DPM (+) patients (38.1% vs. 54.3% in DPM (–)), but this difference was not statistically significant (p=0.298). Native liver survival was 23.8% (DPM+) versus 34.3% (DPM–) (log-rank p=0.55).

Conclusion:
Although DPM was linked to lower jaundice clearance rates, it was not a statistically significant predictor in this cohort. These findings do not support DPM as a standalone prognostic marker for the clearance of jaundice in BA. Larger studies should further explore its interaction with other clinical factors.