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

Abstract：

AIM:To assess the diagnostic value of a laparoscopic finding of a hepatic subcapsular spider-like telangiectasis (HSST) sign in biliary atresia. METHODS:A 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. RESULTS:In 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. CONCLUSION:The HSST sign is characteristic in BA, and laparoscopic exploration for the HSST sign is valuable in the diagnosis of BA.

journal_name

World J Gastroenterol

journal_title

World journal of gastroenterology

authors

Zhou Y,Jiang M,Tang ST,Yang L,Zhang X,Yang DH,Xiong M,Li S,Cao GQ,Wang Y

doi

10.3748/wjg.v23.i39.7119

subject

Has Abstract

pub_date

2017-10-21 00:00:00

pages

7119-7128

issue

eissn

1007-9327

issn

2219-2840

journal_volume

pub_type

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