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  1. Fulltext Percutaneous transhepatic cholangiography -- its place in obstructive jaundice
    Chew PH, Leong LC, Ting PTM, Nath SK
    Med J Malaysia, 1982 Dec;37(4):365-9.
    PMID: 7167090
    The case notes of twelve jaundiced patients, on whom percutaneous transhepatic cholangiography (PTC) were performed, are reviewed. PTC was carried out to differentiate the patients with intrahepatic cholestasis from those with extrahepatic biliary obstruction, and to identify the site and nature of the block. In eleven cases, the biliary trees were visualised, with the sites of obstruction in those present demonstrated and confirmed at subsequent laparotomies. There was no serious side effect from the procedure. PTC in our hands has proved an invaluable aid in the investigation of the icteric patients.
    Matched MeSH terms: Cholangiography/methods*
  2. A prospective multicentre study evaluating the performance of the modified simple biliary atresia scoring system in predicting biliary atresia
    Mahat N, Chiang LW, Chen Y, Razak NHA, Abdullah MY, Sanmugam A, et al.
    Pediatr Surg Int, 2024 Aug 27;40(1):244.
    PMID: 39191932 DOI: 10.1007/s00383-024-05830-w
    PURPOSE: Early diagnosis of biliary atresia (BA) is critical for best outcomes, but is challenged by overlapping clinical manifestations with other causes of obstructive jaundice in neonates. We evaluate the performance of the modified Simple BA Scoring System (SBASS) in diagnosing BA.

    METHODS: We performed a prospective, cross-sectional study on infants with cholestatic jaundice (June 2021-December 2022). Modified SBASS scoring was applied and compared to the eventual diagnosis (as per intraoperative cholangiogram (IOC) and liver histopathology). The score (0-6), consists of gall bladder length  0.7(+ 2), gamma-glutamyl transferase (GGT) ≥ 200 U/L (+ 2).

    RESULTS: 73 were included: Fifty-two (71%) had BA. In the non-BA group, 6 (28%) had percutaneous cholangiography (PTC) while 15 (72%) had intraoperative cholangiogram (IOC). At a cut-off of 3, the modified SBASS showed sensitivity of 96.2%, specificity of 61.9% and overall accuracy of 86.3% in diagnosing BA. Area under receiver operating characteristic curve was 0.901. GGT had the highest sensitivity (94.2%), while triangular cord sign showed the highest specificity at 95.2%.

    CONCLUSION: The SBASS provides a bedside, non-invasive scoring system for exclusion of BA in infantile cholestatic jaundice and reduces the likelihood of negative surgical explorations.

    Matched MeSH terms: Cholangiography/methods
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