Zhang Kaizhi,Chen Yutong,Zheng Zebing,et al.Application value of maximal width of hilar cyst in differentiating cystic biliary atresia from congenital biliary dilatation[J].Journal of Clinical Pediatric Surgery,,22():218-224.[doi:10.3760/cma.j.cn101785-202204027-004]
Application value of maximal width of hilar cyst in differentiating cystic biliary atresia from congenital biliary dilatation
- Keywords:
- Biliary Atresia; Cholangiography; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the application value of ultrasonic measurement of hilar cyst size in differentiating between cystic biliary atresia (CBA) and congenital biliary dilatation (CBD).Methods Retrospective review was conducted for clinical data of 34 hospitalized children with hilar cysts aged <150 days from January 2013 to January 2022.According to the findings of intraoperative cholangiography,they were assigned into two groups of CBA (n=14) and CBD (n=20).General profiles,biochemical parameters,preoperative ultrasonic characteristics,cholangiographic and intraoperative findings between two groups were compared.And receiver operating characteristic curve (ROC) was plotted for examining the diagnostic value of CBA.Results The serum levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBIL) and direct bilirubin (DBIL) differed significantly between two groups (P<0.05).ROC results indicated that maximal cyst width had the highest diagnostic efficiency.Optimal cut-off value was 2.4 cm,area under the ROC curve (AUC) 0.98 and sensitivity and specificity were 91.0% and 95.2% respectively.Optimal cutoff value of maximal cyst length was 3.1 cm,AUC 0.95 and sensitivity and specificity were 91.0% and 85.2% respectively.Optimal cutoff value for maximal cyst length was 0.7 cm,AUC 0.95 and sensitivity and specificity were 91.0% and 89.6% respectively.Optimal cutoff value of maximum cyst width was 2.3 cm,AUC 0.92 and sensitivity and specificity were 80.2% and 85.9% respectively.Optimal cutoff value of maximum cyst length was 3.1 cm,AUC 0.89 and sensitivity and specificity were 90.2% and 78.8% respectively.Conclusion Ultrasonic measurement of maximal cyst width may aid in diagnosing CBA in jaundiced children with postnatal hilar cyst.If ultrasonic examination reveals that cystic width is≤2.3 cm,CBA highly probable.Early cholangiography and surgery are necessary.
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Memo
收稿日期:2022-4-8。
基金项目:国家自然科学基金(81760099);遵市科合HZ字(2019)104号
通讯作者:金祝,Email:915884700@qq.com