دورية أكاديمية
The value of preoperative liver biopsy in the diagnosis of extrahepatic biliary atresia: A systematic review and meta-analysis.
العنوان: | The value of preoperative liver biopsy in the diagnosis of extrahepatic biliary atresia: A systematic review and meta-analysis. |
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المؤلفون: | Lee JY; Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada K1H 8M5., Sullivan K; Children's Hospital of Eastern Ontario, Pediatric Surgery, 401 Smyth Rd, Ottawa, ON, K1H 8L1., El Demellawy D; Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada K1H 8M5; Children's Hospital of Eastern Ontario, Pediatric Pathology, 401 Smyth Rd, Ottawa, ON, K1H 8L1., Nasr A; Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada K1H 8M5; Children's Hospital of Eastern Ontario, Pediatric Surgery, 401 Smyth Rd, Ottawa, ON, K1H 8L1. Electronic address: anasr@cheo.on.ca. |
المصدر: | Journal of pediatric surgery [J Pediatr Surg] 2016 May; Vol. 51 (5), pp. 753-61. Date of Electronic Publication: 2016 Feb 13. |
نوع المنشور: | Journal Article; Meta-Analysis; Review; Systematic Review |
اللغة: | English |
بيانات الدورية: | Publisher: Saunders Country of Publication: United States NLM ID: 0052631 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5037 (Electronic) Linking ISSN: 00223468 NLM ISO Abbreviation: J Pediatr Surg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Philadelphia, PA : Saunders Original Publication: New York. |
مواضيع طبية MeSH: | Preoperative Care*, Biliary Atresia/*diagnosis , Biliary Atresia/*pathology , Liver/*pathology, Biliary Atresia/surgery ; Biopsy ; Humans ; Infant ; Infant, Newborn ; Sensitivity and Specificity |
مستخلص: | Background: In extrahepatic biliary atresia (EHBA) obstruction of the biliary tree causes severe cholestasis leading to cirrhosis and death if left untreated in a timely manner. Infants with cholestasis may undergo many tests before EHBA diagnosis is reached. The role and place of preoperative liver biopsy in the diagnostic paradigm for EHBA have not been established. Methods: We conducted a systematic review of MEDLINE, Embase, and CENTRAL to obtain all publications describing the sensitivity/specificity/accuracy/positive predictive value (PPV)/negative predictive value (NPV) of preoperative liver biopsy in infants with cholestasis. Screening, data extraction, and quality assessment were done in duplicate. Extracted data are described narratively and analyzed using forest plots and receiver operating characteristic curves. Results: A total of 22 articles were included. Overall, the pooled accuracy of preoperative liver biopsy was 91.7%, with a sensitivity of 91.2%, specificity of 93.0% (n=1231), PPV of 91.2%, NPV of 92.5% (n=1182), and accuracy of 91.6% (n=1106). In patients who were 60days or less at time of presentation or diagnosis, the pooled sensitivity, specificity, PPV, NPV, and accuracy were 96.4%, 96.3%, 95.8%, 96.3%, and 94.9%, respectively. Conclusion: Quantitative analysis demonstrated preoperative biopsy to be both highly specific and sensitive in diagnosing EHBA preoperatively. It is a highly reliable test that offers a means of arriving at an early definitive diagnosis of EHBA. (Copyright © 2016 Elsevier Inc. All rights reserved.) |
فهرسة مساهمة: | Keywords: Biliary atresia; Preoperative liver biopsy |
تواريخ الأحداث: | Date Created: 20160303 Date Completed: 20170414 Latest Revision: 20181202 |
رمز التحديث: | 20240628 |
DOI: | 10.1016/j.jpedsurg.2016.02.016 |
PMID: | 26932252 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1531-5037 |
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DOI: | 10.1016/j.jpedsurg.2016.02.016 |