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Erschienen in: Surgery Today 10/2020

20.04.2020 | Original Article

The duodenal tube test is more specific than hepatobiliary scintigraphy for identifying bile excretion in the differential diagnosis of biliary atresia

verfasst von: Daiki Yoshii, Yukihiro Inomata, Hirotoshi Yamamoto, Tomoaki Irie, Masashi Kadohisa, Kenji Okumura, Kaori Isono, Masaki Honda, Shintaro Hayashida, Yuki Oya, Taizo Hibi

Erschienen in: Surgery Today | Ausgabe 10/2020

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Abstract

Purpose

Confirmation of bile excretion into the gastrointestinal tract is important to exclude biliary atresia (BA). We compared the duodenal tube test (DTT) with hepatobiliary scintigraphy (HS) for their efficiency in detecting bile secretion.

Methods

The subjects of this retrospective study were 47 infants who underwent both DTT and HS to diagnose or exclude BA between January 2000 and March 2018.

Results

BA was diagnosed in 32 of the 47 patients, and 7 of the remaining 15 non-BA patients underwent intraoperative cholangiography. Among the various DTT parameters, the total bile acid in duodenal fluid (DF-TBA)/serum (S) gamma-glutamyl transferase (γGTP) ratio was found to be the most specific for BA, with sensitivity and specificity of 98.0–100%, respectively. One BA patient in whom cut off values were not met was a premature infant. The sensitivity and specificity of HS were 100–56.3%, respectively. The diagnostic accuracy of the DF-TBA/S-γGTP parameter was higher than that of HS (98.6% vs. 85.1%, respectively).

Conclusions

The DTT could be more a specific method than HS to detect bile excretion. Thus, the DTT should be incorporated into the multidisciplinary diagnostic approach for the differential diagnosis of BA to prevent unnecessary intraoperative cholangiography in patients who do not have BA.
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Metadaten
Titel
The duodenal tube test is more specific than hepatobiliary scintigraphy for identifying bile excretion in the differential diagnosis of biliary atresia
verfasst von
Daiki Yoshii
Yukihiro Inomata
Hirotoshi Yamamoto
Tomoaki Irie
Masashi Kadohisa
Kenji Okumura
Kaori Isono
Masaki Honda
Shintaro Hayashida
Yuki Oya
Taizo Hibi
Publikationsdatum
20.04.2020
Verlag
Springer Singapore
Erschienen in
Surgery Today / Ausgabe 10/2020
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-02010-w

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