Liver elasticity measurement before and after biliary drainage in patients with obstructive jaundice: a prospective cohort studya prospective cohort study

Kimitoshi Kubo; Hiroshi Kawakami; Masaki Kuwatani; Mutsumi Nishida; Kazumichi Kawakubo; Shuhei Kawahata; Yoko Taya; Yoshimasa Kubota; Toraji Amano; Hiroki Shirato; Naoya Sakamoto

doi:10.1186/s12876-016-0479-3

Liver elasticity measurement before and after biliary drainage in patients with obstructive jaundice: a prospective cohort studya prospective cohort study

BMC Gastroenterol. 2016 Jul 8;16(1):65. doi: 10.1186/s12876-016-0479-3.

Authors

Kimitoshi Kubo¹, Hiroshi Kawakami^{2

3}, Masaki Kuwatani⁴, Mutsumi Nishida⁵, Kazumichi Kawakubo⁶, Shuhei Kawahata¹, Yoko Taya¹, Yoshimasa Kubota^{1

7}, Toraji Amano⁸, Hiroki Shirato⁹, Naoya Sakamoto⁶

Affiliations

¹ Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
² Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan. hiropon@med.miyazaki-u.ac.jp.
³ Department of Gastroenterology and Hepatology, Center for Digestive Disease, University of Miyazaki, 5200 Kihara, Kiyotake-cho, Miyazaki City, 889-1692, Japan. hiropon@med.miyazaki-u.ac.jp.
⁴ Division of Endoscopy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
⁵ Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
⁶ Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
⁷ Department of Gastroenterology and Hepatology, Center for Digestive Disease, University of Miyazaki, 5200 Kihara, Kiyotake-cho, Miyazaki City, 889-1692, Japan.
⁸ Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
⁹ Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.

Abstract

Background: Obstructive jaundice has been reported to influence liver elasticity, independent of liver fibrosis. The aim of our prospective study was to evaluate the changes in liver elasticity, before and after biliary drainage, in patients with obstructive jaundice, and to evaluate the correlation between elasticity measures and serum markers of liver fibrosis.

Methods: This is a prospective cohort study of 20 patients with obstructive jaundice. Liver elasticity was assessed by Transient Elastography (TE) and Virtual Touch™ Quantification (VTQ). Serum total bilirubin (T-Bil) level was measured before biliary drainage (Day 0), with measures repeated at 2 days (Day 2) and 7 days (Day 7) after biliary drainage. Serum levels of the following markers of liver fibrosis were also obtained on Day 0 and Day 7: hyaluronic acid (HA), procollagen-III-peptide (P-III-P).

Results: T-Bil, TE, and VTQ for the left (VTQ-L) and right (VTQ-R) lobes of the liver were all elevated before biliary drainage, with respective levels, measured at Day 0, of 11.9 ± 1.5 mg/dl, 12.1 ± 0.9 kPa, 2.23 ± 0.10 m/s, and 1.85 ± 0.10 m/s. All values decreased on Day 7 after drainage: T-Bil, 4.7 ± 1.0 mg/dl (P < 0.001); TE, 7.6 ± 0.6 kPa (P < 0.001); VTQ-L, 1.53 ± 0.08 m/s (P < 0.001); and VTQ-R, 1.30 ± 0.05 m/s (P < 0.001). Similar changes were observed in serum markers of liver fibrosis. Liver elasticity measures correlated with serum levels of T-Bil, P-III-P, and HA (r = 0.35-0.67, P < 0.001).

Conclusions: This study confirmed decreases in liver elasticity, measured by TE and VTQ, after biliary drainage. Measures of liver elasticity correlated to levels of T-Bil and serum markers of liver fibrosis. (UMIN ID: UMIN00001284313).

Registration number: University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN ID: UMIN00001284313 ); Registration date: 2014-01-14.

Keywords: Biliary drainage; Hyaluronic acid; Liver Elasticity; Liver fibrosis; Obstructive jaundice; Procollagen-III-peptide; Transient elastography; Virtual Touch™ Quantification.

MeSH terms

Aged
Aged, 80 and over
Bilirubin / blood
Biomarkers / blood
Drainage / methods*
Elasticity
Elasticity Imaging Techniques
Female
Humans
Hyaluronic Acid / blood
Jaundice, Obstructive / blood
Jaundice, Obstructive / diagnostic imaging
Jaundice, Obstructive / physiopathology*
Jaundice, Obstructive / surgery*
Liver / diagnostic imaging
Liver / physiopathology*
Liver Cirrhosis / diagnosis
Male
Middle Aged
Peptide Fragments / blood
Procollagen / blood
Prospective Studies

Substances

Biomarkers
Peptide Fragments
Procollagen
procollagen Type III-N-terminal peptide
Hyaluronic Acid
Bilirubin