The Evaluation of Laparoscopy-Assisted Cholangiography in the Diagnosis of Prolonged Jaundice in Infants

Tang, Shaotao; Li, Shiwang; Ying, Yang; Mao, Yong-Zhong; Yong, Wang; Tong, Qiangsong

doi:10.1089/lap.2008.0432

Cited by 15 publications

(8 citation statements)

References 7 publications

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“…In our series, tru-cut biopsy supplied so satisfactory information that we did not need to take liver biopsy intracorporally via inserting additional trocars. In other series, during laparoscopic evaluation, cholangiogram was reported to be performed either by exteriorizing the gallbladder through the incision of the working port [ 4 , 5 ] or by hitching the gallbladder to the lateral aspect of the abdominal wall [ 6 ]. Şenyüz et al reported the importance of early diagnosis of surgical jaundice in a neonate for surgical success.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy-Assisted Percutaneous Cholangiography in Biliary Atresia Diagnosis: Comparison with Open Technique

Alkan

Tutuş

Fakıoğlu

et al. 2016

Gastroenterology Research and Practice

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Introduction. Biliary atresia is a surgical cause of prolonged jaundice, which needs to be diagnosed with cholangiography that has traditionally been performed via laparotomy. Laparoscopic assistance has lately been introduced to avoid unnecessary laparotomy. We aim to evaluate the benefits of the laparoscopy-assisted cholangiography and compare it to the traditional procedure via laparotomy. Patients and Method. The medical records of the cases who had undergone cholangiography for prolonged jaundice between 2007 and 2014 were analyzed. The patients were grouped according to cholangiography technique (laparotomy/laparoscopy). The laparoscopy and laparotomy groups with patent bile ducts were focused and compared in terms of operation duration, postoperative initiation time of enteral feeding, and full enteral feeding achievement time. Results. Sixty-one infants with prolonged jaundice were evaluated between 2007 and 2014. Among the patients with patent bile ducts, operation duration, postoperative enteral feeding initiation time, and the time to achieve full enteral feeding were shorter in laparoscopy group. Conclusion. Laparoscopic cholangiography is safe and less time-consuming compared to laparotomy, with less postoperative burden. As early age of operation is a very important prognostic factor, laparoscopic evaluation should be an early option in work-up of the infants with prolonged jaundice with direct hyperbilirubinemia, for diagnosis/exclusion of biliary atresia.

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Section: Discussionmentioning

confidence: 99%

Laparoscopy-Assisted Percutaneous Cholangiography in Biliary Atresia Diagnosis: Comparison with Open Technique

Alkan

Tutuş

Fakıoğlu

et al. 2016

Gastroenterology Research and Practice

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“…The enrollment criteria in our series included the following: (1) icterus was gradually aggravated after the first 3-4 wk; (2) consistent depigmented stool; and (3) traditional diagnostic examinations ( i.e ., physical examination, blood biochemical examination, ultrasonography, hepatobiliary scintigraphy, MRCP, etc .) failed to achieve a deﬁnitive diagnosis[ 20 ]. The children’s general information, including gender, age and biochemical parameters [the level of total and direct serum bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gammaglutamyl transpeptidase (GGT)] were carefully documented.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, with the application of laparoscopy in pediatric surgery, laparoscopy-assisted cholangiography (LAC) has become possible. In our center, we performed laparoscopy-assisted cholangiography on infants who were highly suspected of having BA before the Kasai portoenterostomy was developed[ 20 ]. During the procedure, we found that a prominent pathological change on the liver surface - a hepatic subcapsular spider-like telangiectasis (HSST) sign - had a strong correlation with BA.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic finding of a hepatic subcapsular spider-like telangiectasis sign in biliary atresia

Zhou¹,

Jiang²,

Tang³

et al. 2017

WJG

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AIMTo assess the diagnostic value of a laparoscopic finding of a hepatic subcapsular spider-like telangiectasis (HSST) sign in biliary atresia.METHODSA retrospective study was conducted first and then a validation set was used to investigate the value of an HSST sign in predicting biliary atresia (BA). In the retrospective study, laparoscopic images of the liver surface were reviewed in 126 patients with infantile cholestasis (72 BA patients and 54 non-BA cholestasis patients) and a control group of 38 patients with non-hepatic conditions. Analysis was first made by two observers separately and finally, a consensus conclusion was achieved. Then, the diagnostic value of the HSST sign was validated in an independent cohort including 45 BA and 45 non-BA patients.RESULTSIn the retrospective investigation, an ampliﬁed HSST sign was found in all BA patients, while we were unable to detect the HSST sign in 98.1% of the 54 non-BA patients. There was no HSST sign in any of the control subjects. In the first review, the sensitivity and specificity from one reviewer were 100% and 98.1%, respectively, and the results from the other reviewer were both 100%. The consensus sensitivity and specificity were 100% and 98.1%, respectively. The HSST sign was defined as being composed of several enlarged tortuous spider-like vascular plexuses with two to eight branches distributed on all over the liver surface, which presented as either a concentrated type or a dispersed type. In the independent validation group, the sensitivity, specificity, positive predictive value and negative predictive value of the HSST sign were 100%, 97.8%, 97.8% and 100%, respectively.CONCLUSIONThe HSST sign is characteristic in BA, and laparoscopic exploration for the HSST sign is valuable in the diagnosis of BA.

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“…The most important and frequently encountered differential diagnosis is neonatal hepatitis. Tang et al [2] noted that 8 out of 38 patients who underwent laparoscopic cholangiography had hepatitis. Senyüz et al [3] also noted 10 of 24 cases proved to have neonatal hepatitis.…”

Section: Laparoscopic Cholecystostomy and Bile Duct Lavage For Treatmmentioning

confidence: 99%

To the editor

Yeh

Chang

2012

World J Pediatr

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The Evaluation of Laparoscopy-Assisted Cholangiography in the Diagnosis of Prolonged Jaundice in Infants

Abstract: Laparoscopy-assisted cholangiography is a simple, accurate, and safe method in the diagnosis of prolonged jaundice in infants and allows the anatomic structure of the biliary tree to be obtained accurately with minimal surgical intervention.

Cited by 15 publications

References 7 publications

Laparoscopy-Assisted Percutaneous Cholangiography in Biliary Atresia Diagnosis: Comparison with Open Technique

Laparoscopy-Assisted Percutaneous Cholangiography in Biliary Atresia Diagnosis: Comparison with Open Technique

Laparoscopic finding of a hepatic subcapsular spider-like telangiectasis sign in biliary atresia

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