Departments of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Departments of Pediatrics, New Taipei City Hospital, New Taipei City, Taiwan.
J Pediatr Gastroenterol Nutr. 2024 Aug;79(2):222-228. doi: 10.1002/jpn3.12278. Epub 2024 Jun 3.
Biliary atresia (BA) is the leading cause of liver cirrhosis and chronic liver insufficiency in children in the world. Gastroesophageal varices bleeding is an ominous complication of cirrhosis in BA patients and is associated with high morbidity and mortality. In this study, we aimed to investigate the utility of noninvasive Baveno VI and Baveno VII criteria for the screening of varices need treatment (VNT) and the need for liver transplantation in BA patients.
This study enrolled 48 BA patients (23 females and 25 males) who underwent an esophagogastroduodenoscopy (EGD) and transient elastography at a mean age of 11.18 ± 1.48 years; the clinical data were surveyed in a retrospective design.
The sensitivity and negative predictive value of Baveno VI and Baveno VII criteria for the prediction of VNT in BA patients are both 100% and 100%, respectively. The VNT missing rate of Baveno VI and Baveno VII criteria are both 0% in our cohort. The Baveno VI, expanded Baveno VI, and Baveno VII criteria are also predictive of the need for liver transplantation in our cohort (OR = 10.33, 4.24, and 21.33; p = 0.009, 0.03, and 0.007, respectively).
The Baveno VI and Baveno VII criteria are useful for the screening of VNT and minimize non-necessary invasive EGD in BA patients with low VNT missing rates. The Baveno VI, expanded Baveno VI, and Baveno VII criteria are associated with the need for liver transplantation.
胆道闭锁（BA）是全球导致儿童肝硬化和慢性肝功能不全的主要原因。胃食管静脉曲张出血是 BA 患者肝硬化的一个严重并发症，与高发病率和死亡率相关。本研究旨在探讨无创性 Baveno VI 和 Baveno VII 标准在 BA 患者中用于筛查需要治疗的静脉曲张（VNT）和肝移植的应用价值。
本研究纳入了 48 名 BA 患者（23 名女性和 25 名男性），他们在平均年龄为 11.18±1.48 岁时接受了食管胃十二指肠镜检查（EGD）和瞬时弹性成像检查；采用回顾性设计对临床数据进行了调查。
Baveno VI 和 Baveno VII 标准对 BA 患者 VNT 的预测的敏感性和阴性预测值均为 100%，分别为 100%。Baveno VI 和 Baveno VII 标准在我们的队列中 VNT 漏诊率均为 0%。Baveno VI、扩展的 Baveno VI 和 Baveno VII 标准也可预测我们队列中肝移植的需求（OR=10.33、4.24 和 21.33；p=0.009、0.03 和 0.007）。
Baveno VI 和 Baveno VII 标准可用于 BA 患者 VNT 的筛查，具有低 VNT 漏诊率，最大限度地减少不必要的有创性 EGD。Baveno VI、扩展的 Baveno VI 和 Baveno VII 标准与肝移植的需求相关。
