Postsurgical Management of Dilated Biliary Tract in Children: Ultrasound-Guided Percutaneous Transhepatic Cholangial Drainage and Subsequent Percutaneous Ultrasound Cholangiography.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: American Roentgen Ray Society Country of Publication: United States NLM ID: 7708173 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1546-3141 (Electronic) Linking ISSN: 0361803X NLM ISO Abbreviation: AJR Am J Roentgenol Subsets: MEDLINE
    • Publication Information:
      Publication: <2004-> : Leesburg, VA : American Roentgen Ray Society
      Original Publication: Springfield, Ill., Thomas.
    • Subject Terms:
      Cholangiography* ; Ultrasonography, Interventional*; Biliary Tract Diseases/*surgery ; Drainage/*methods ; Postoperative Complications/*diagnostic imaging ; Postoperative Complications/*therapy; Bile Ducts, Intrahepatic ; Bilirubin/blood ; Child ; Child, Preschool ; Contrast Media ; Dilatation, Pathologic ; Feasibility Studies ; Female ; Humans ; Infant ; Liver Function Tests ; Male ; Microbubbles
    • Abstract:
      OBJECTIVE. The purpose of this study was to evaluate the feasibility of ultrasound (US)-guided percutaneous transhepatic cholangial drainage (PTCD) and consequent percutaneous US cholangiography in managing the dilated biliary tracts of children who have undergone hepatobiliary surgery. SUBJECTS AND METHODS. Sixteen children (11 boys, five girls; age range, 3-144 months) who underwent hepatobiliary surgery from December 2016 to October 2018 and had US evidence of biliary dilatation were included. All patients had undergone US-guided PTCD because of elevated postoperative serum bilirubin levels or bile duct infection. Immediately after the PTCD procedure, diluted sulphur hexafluoride microbubbles dispersion was injected through the PTCD tube to evaluate the anastomosis and the intrahepatic bile duct tree. Laboratory results, including those of serum bilirubin measurement, liver function tests, and routine blood tests, were evaluated before and after PTCD. Nine of 16 patients also underwent percutaneous transhepatic cholangiography (PTC). The percutaneous US cholangiography findings were evaluated and compared with the PTC findings. RESULTS. Liver enzyme levels decreased after PTCD with a statistically significant difference from the values before PTCD. Percutaneous US cholangiography showed that the anastomosis in 6 of the 16 patients (37.5%) was patent and depicted the morphologic featuresof intrahepatic bile duct tree in five of these patients. In the other 10 patients, the anastomosis was completely obstructed, and percutaneous US cholangiography depicted the morphologic features of intrahepatic bile duct tree in eight patients. In the nine patients who underwent PTC, the percutaneous US cholangiographic findings were the same as the PTC findings. CONCLUSION. US-guided PTCD is helpful in relieving jaundice and inflammation in children who have undergone hepatobiliary surgery and have biliary dilatation. Findings at consequent percutaneous US cholangiography are comparable to those of PTC in depicting the anastomosis in these patients.
    • Contributed Indexing:
      Keywords: children; cholangiography; drainage; sonography
    • Accession Number:
      0 (Contrast Media)
      RFM9X3LJ49 (Bilirubin)
    • Publication Date:
      Date Created: 20200312 Date Completed: 20200702 Latest Revision: 20200702
    • Publication Date:
      20221213
    • Accession Number:
      10.2214/AJR.19.22225
    • Accession Number:
      32160054