EN
TÜRKÇE
Poster - 298
Evaluation and Comparison of Histopathological Parameters of Core Needle Biopsy with Subcapsular Liver Biopsy in Biliary Atresia Children: A Cross-Sectional Study
Shailesh Solanki, Palak Singhai, Ravi Kanojia, Chimmani Sai Kiran, Nitin James Peter, Suvradeep Mithra, Sadhna B Lal, Jai Kumar Mahajan
PGIMER, Chandigarh, India
Purpose: Percutaneous core needle liver biopsy (CNB) is widely used for the pre-operative diagnosis of biliary atresia (BA). Subcapsular wedge liver biopsy (WB), obtained during Kasai portoenterostomy (KPE), is considered essential. The comparative utility of CNB and WB in BA remains uncertain. This study aimed to (i) compare the histopathological features of CNB and WB, (ii) evaluate the necessity of performing CNB alongside WB during KPE, and (iii) determine if WB can be omitted in patients who have undergone preoperative CNB.
Methods: A retrospective, cross-sectional study was conducted at a tertiary care institute, including BA patients who had undergone preoperative CNB and subsequent intraoperative WB during KPE between 2018 and 2023. Histopathological parameters were analyzed and compared.
Results: A total of 14 children were included. All patients exhibited liver fibrosis on both CNB and WB. Additionally, portal inflammation (PI) and stromal edema (SE) were observed in all on CNB. Ductular reaction (DR), ductular cholestasis (DC), and lobular cholestasis (LC) were also identified in all patients except one. Ductal plate malformation (DPM) was present in 14.3% of CNB and 35.7% of WB. A higher incidence of DPM and a higher grade of fibrosis, DR, PI, and LC were observed on WB compared to CNB. Conversely, a higher incidence of portal vein abortive (PVA) and a higher grade of cellular death (CD) were noted on CNB. No statistically significant difference was identified in any parameter between the two biopsy methods.
Conclusion: Both CNB and WB provide comparable diagnostic insights in BA. Specific histological parameters were more evident in CNB (PVA, CD), while others were more prominent in WB (fibrosis, DR, DPM, PI, and LC). CNB has a definitive diagnostic role preoperatively. While WB remains crucial during KPE for prognostication, adding intraoperative CNB may not provide additional benefits information.