Evaluating the Effect of Preoperative Corticosteroid Therapy in Biliary Atresia with Kasai Operation Based on Histological Changes of Liver Biopsy (A Stereological Study)
Objective: This study evaluates the effect of preoperative steroid therapy in infants with biliary atresia by evidences those obtained by stereological study of liver biopsies.
Materials and Methods: Five patients who was diagnosed as biliary atresia was selected and was treated with a hepatoportoenterostomy (Kasai) operation. All patients receive a routine protocol of preoperative steroid treatment as follows: methylprednisolone 10, 8, 6 mg/kg×3days after the time of diagnosis till the day of operation. Two liver biopsies were taken from all of the infants at the time of diagnosis and at the time of hepatic portoenterostomy. They were evaluated with stereological study for volume density of connective tissue, fibrosis, hepatocytes, bile duct and sinusoid, the diameter of duct, endothelium and lumen, the lenght density of duct, numerical density cell and the mean volume of hepatocyte and nucleus.
Results: The analysis of the data revealed that the mean total volume density of the connective tissue decreased ~ 12% in operative biliary atresia (steroid treated) group in comparison with preoperative biliary atresia group. But, the other parameters did not show any significant changes.
Conclusion: According to our results, we found that preoperative corticosteroid therapy in biliary atretic patients cannot decrease the volume density of portal fibrosis significantly, and also ductular proliferation has no any significant changes with preoperative corticosteroid therapy.