Ridaura Sanz C, Navarro Castilla E
Departamento de Patología, Instituto Nacional de Pediatría, México, D.F.
Rev Invest Clin. 1992 Apr-Jun;44(2):193-202.
Liver biopsy in the diagnosis of the results of a retrospective analysis of percutaneous liver biopsy in the differential diagnosis of prolonged cholestasis in infancy are reported. We compare the clinical features, serum bilirubin levels, hepatobiliary scintigraphy and histology in two groups of patients. One group of 56 patients had extrahepatic biliary obstruction (biliary atresia: 42; choledochal cyst: 9; extrinsic obstruction: 4; Caroli's disease: 1). Another group of 54 children had intrahepatic cholestasis with patent biliary tract (hepatitis: 38; non-specific cholestasis: 14; cirrhosis: 2). The percutaneous liver biopsy was better than the other procedures to differentiate biliary atresia from hepatitis. We conclude that percutaneous liver biopsy should be carried out in children with prolonged cholestasis when other non-invasive procedures have not ruled out extrahepatic biliary obstruction and before any surgical exploration of the biliary tract is performed.
报告了经皮肝穿刺活检在婴儿期长期胆汁淤积鉴别诊断中的诊断结果的回顾性分析。我们比较了两组患者的临床特征、血清胆红素水平、肝胆闪烁显像和组织学。一组56例患者有肝外胆管梗阻(胆道闭锁:42例;胆总管囊肿:9例;外在性梗阻:4例;卡罗利病:1例)。另一组54例儿童有肝内胆汁淤积且胆道通畅(肝炎:38例;非特异性胆汁淤积:14例;肝硬化:2例)。经皮肝穿刺活检在鉴别胆道闭锁与肝炎方面优于其他检查方法。我们得出结论,当其他非侵入性检查未排除肝外胆管梗阻时,且在进行任何胆道手术探查之前,对于长期胆汁淤积的儿童应进行经皮肝穿刺活检。