{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T19:23:57Z","timestamp":1793129037223,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,11,3]],"date-time":"2017-11-03T00:00:00Z","timestamp":1509667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2018,4]]},"abstract":"Aim<\/jats:title>Cystic biliary atresia (CBA<\/jats:styled-content>) can be easily misdiagnosed as choledochal cyst (CC<\/jats:styled-content>). Some patients have already progressed to severe liver fibrosis and missed the optimal surgical time, when the differential diagnosis is made. We aim to determine the differentiation between CBA<\/jats:styled-content> and CC<\/jats:styled-content>, and to validate the value of aspartate aminotransferase\u2010to\u2010platelet ratio index (APRI<\/jats:styled-content>) in the assessment of liver fibrosis and prediction of post\u2010operative outcome for infants with biliary cystic malformations (BCMs<\/jats:styled-content>).<\/jats:p><\/jats:sec>Methods<\/jats:title>Clinical data of children (categorised into CBA<\/jats:styled-content> and CC<\/jats:styled-content> groups) with BCMs<\/jats:styled-content> were analysed retrospectively. Biochemical indicators together with B\u2010ultrasound examinations and the degree of liver fibrosis were analysed, and those with statistical difference between the two groups were selected for diagnostic receiver operating characteristic curve analysis.<\/jats:p><\/jats:sec>Results<\/jats:title>The parameter that showed the highest accuracy with a significant diagnostic performance for differentiating CBA<\/jats:styled-content> from CC<\/jats:styled-content> was cyst size. Liver assessment at operation was categorised into mild fibrosis and moderate\u2010to\u2010severe fibrosis. The APRI<\/jats:styled-content> values were much lower in the mild fibrosis groups than in the moderate\u2010to\u2010severe fibrosis group (0.4\u2009\u00b1\u20090.2 vs. 1.4\u2009\u00b1\u20090.8, P<\/jats:italic>\u2009<\u20090.001). A cut\u2010off value of 0.96 (area under the curve 0.92, P<\/jats:italic>\u2009<\u20090.001) showed a sensitivity of 81.3% and a specificity of 100% for moderate\u2010to\u2010severe fibrosis. Lower APRI<\/jats:styled-content> value was correlated with short\u2010term post\u2010operative bilirubin clearance.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>There is still certain difficulty in the early identification of CBA<\/jats:styled-content> and CC<\/jats:styled-content> clinically. Liver fibrosis could occur as early as infantile period in both CBA<\/jats:styled-content> and CC<\/jats:styled-content>. In infants with BCMs<\/jats:styled-content>, APRI<\/jats:styled-content> can be used as a non\u2010invasive method to detect liver fibrosis in early stages.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.13779","type":"journal-article","created":{"date-parts":[[2017,11,3]],"date-time":"2017-11-03T17:16:37Z","timestamp":1509729397000},"page":"383-389","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Differentiation between cystic biliary atresia and choledochal cyst: A retrospective analysis"],"prefix":"10.1111","volume":"54","author":[{"given":"Jue","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery, Zhujiang Hospital Southern Medical University Guangzhou Guangdong Province China"},{"name":"Department of Surgery Guangzhou Women and Children's Medical Center Guangzhou Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center The First Affiliated Hospital of Sun Yat\u2010Sen University Guangzhou Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery Guangzhou Women and Children's Medical Center Guangzhou Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji\u2010Xiao","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Surgery Guangzhou Women and Children's Medical Center Guangzhou Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Kang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Surgery Guangzhou Women and Children's Medical Center Guangzhou Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Zhujiang Hospital Southern Medical University Guangzhou Guangdong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2007.12.058"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-002-0843-y"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.03.054"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2000.19248"},{"key":"e_1_2_9_6_1","first-page":"43","article-title":"Neonatal cholestasis \u2013 Differential diagnoses, current diagnostic procedures, and treatment","volume":"3","author":"Gotze T","year":"2015","journal-title":"Front Pediatr."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1015-9584(09)60306-7"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-006-1771-z"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00281-009-0171-6"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922811406264"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-013-3368-7"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1063393"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60946-6"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000189324.80323.a6"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-013-3453-y"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000319373"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1556\/OH.2010.28978"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2003.50346"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.11.046"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i19.5893"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2012.10.010"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2012.31.6.833"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2010.29.11.1581"},{"key":"e_1_2_9_24_1","first-page":"253","article-title":"Improvement in accuracy of gamma\u2010glutamyl transferase for differential diagnosis of biliary atresia by correlation with age","volume":"50","author":"Rendon\u2010Macias ME","year":"2008","journal-title":"Turk. 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