Coagulopathy in a subtype of choledochal cyst and management strategy

Table 1 Comparison of liver function between choledochal cyst patients with and without stenotic distal common bile ducts n (%)

	Stenotic (n = 336)	Non-stenotic (n = 104)	P value
Abnormal liver function	313 (93.2)	67 (64.4)1	< 0.001
Normal liver function	23 (6.8)	37 (35.6)

¹Protein plugs in common channels were detected in all choledochal cyst patients with non-stenotic distal common bile ducts and abnormal liver function.

Table 2 Coagulopathy in choledochal cyst children with and without stenotic distal common bile ducts n (%)

	Stenotic (n = 93)	Non-stenotic (n = 67)	P value
FIB 1-2 g/L (n = 124)	71 (88)	36 (29)	< 0.001
FIB < 1 g/L (n = 36)	5 (13.9)	31 (86.1)

FIB: Fibrinogen (Reference range: 2-4 g/L).

Table 3 Perioperative laboratory tests in choledochal cyst children with and without coagulopathy

		CDC without coagulopathy (n = 280)	CDC with coagulopathy (n = 160)
			FIB 1-2 g/L (n = 124)	FIB ≥ 1 g/L after medication (n = 24)	FIB ≥ 1 g/L after external drainage (n = 12)
TBIL (µmol/L)	Pre-op	168.64 ± 90.22	201.57 ± 71.64	234.77 ± 23.98	254.97 ± 17.63
Ref: 3.4-20	Post-op	11.03 ± 5.68	16.57 ± 4.39	17.25 ± 5.88	18.75 ± 2.66
ALT (U/L)	Pre-op	99.15 ± 46.39	182.11 ± 74.52	219.02 ± 13.72	231.04 ± 12.34
Ref: < 40	Post-op	16.16 ± 8.74	24.80 ± 8.29	31.14 ± 10.38	36.12 ± 6.01
AST (U/L)	Pre-op	100.77 ± 45.95	184.19 ± 74.58	220.26 ± 13.19	230.82 ± 10.27
Ref: < 40	Post-op	18.11 ± 8.67	28.71 ± 9.49	32.07 ± 10.55	38.92 ± 2.96
ALP (U/L)	Pre-op	526.42 ± 135.72	728.99 ± 118.35	755.08 ± 57.35	813.75 ± 53.51
Ref: < 400	Post-op	140.68 ± 43.72	151.75 ± 29.50	161.16 ± 47.24	188.58 ± 54.88
GGT (U/L)	Pre-op	295.68 ± 192.57	405.93 ± 161.46	609.42 ± 87.32	688.83 ± 39.03
Ref: 7-50	Post-op	26.72 ± 12.30	30.38 ± 9.76	36.75 ± 3.45	38.70 ± 2.02
SAMY (U/L)	Pre-op	130.96 ± 111.76	312.31 ± 286.55	678.91 ± 298.26	801.13 ± 92.68
Ref: 25-125	Post-op	27.28 ± 9.52	32.22 ± 13.89	38.62 ± 16.38	51.25 ± 10.68
P value (pre- vs post-operation)		< 0.001	< 0.001	< 0.001	< 0.001

CDC: Choledochal cyst; ALT: Alanine transaminase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: γ-Glutamyl transpeptidase; TBIL: Total bilirubin; SAMY: Serum amylase.