Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.
Department of Intervention Radiology, Institute of Liver and Biliary Sciences, New Delhi, India.
Indian J Pediatr. 2022 Nov;89(11):1144-1147. doi: 10.1007/s12098-022-04354-2. Epub 2022 Sep 20.
The objective of this study was to evaluate the feasibility, safety, and diagnostic accuracy of percutaneous cholecystocholangiography (PCC) in cases of conjugated hyperbilirubinemia in which biliary atresia (BA) could not be diagnosed or ruled out based on clinical, radiological, and histopathological findings. This was a retrospective, chart review of all cholestatic infants who underwent PCC within the last 5 y. PCC was performed via the transhepatic route using 23-g needle. The patency of both the proximal and distal biliary trees was assessed. PCC was technically feasible in 12/13 (92.3%) of infants without any procedure-related complications. PCC demonstrated proximal and distal biliary patencyin 7/12 (58.3%) infants, thereby avoiding unnecessary laparotomy in them. PCC failed to demonstrate biliary patency in 5 infants; of which, 4 were confirmed as cases of BA on laparotomy. PCC can correctly differentiate BA from non-BA cases of conjugated hyperbilirubinemia preoperatively, reducing the negative laparotomy rates.
本研究旨在评估经皮胆囊胆管造影术（PCC）在临床、影像学和组织病理学检查不能诊断或排除先天性胆道闭锁（BA）的结合胆红素升高病例中的可行性、安全性和诊断准确性。这是一项回顾性研究，对过去 5 年内接受 PCC 的所有胆汁淤积性婴儿的病历进行了回顾。PCC 通过经肝途径使用 23 号针进行。评估近端和远端胆道的通畅性。13 例婴儿中的 12 例（92.3%）PCC 技术可行，无任何与操作相关的并发症。PCC 显示 7/12（58.3%）婴儿近端和远端胆道通畅，从而避免了他们不必要的剖腹手术。5 例婴儿 PCC 未能显示胆道通畅；其中 4 例在剖腹手术中被确认为 BA 病例。PCC 可在术前正确区分 BA 和非 BA 型结合性高胆红素血症，降低阴性剖腹手术率。
