Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Postoperative Imaging Findings of Biliary Atresia

담도폐쇄증의 수술 후 영상 소견

  • Jisun Hwang (Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Hee Mang Yoon (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Pyeong Hwa Kim (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Jung-Man Namgoong (Department of Pediatric Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • Seak Hee Oh (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine) ;
  • Ah Young Jung (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Jin Seong Lee (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Young Ah Cho (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center)
  • 황지선 (한림대학교 의과대학 동탄성심병원 영상의학과) ;
  • 윤희망 (울산대학교 의과대학 서울아산병원 영상의학과) ;
  • 김평화 (울산대학교 의과대학 서울아산병원 영상의학과) ;
  • 남궁정만 (울산대학교 의과대학 서울아산병원 어린이병원 소아외과) ;
  • 오석희 (울산대학교 의과대학 서울아산병원 어린이병원 소아청소년과) ;
  • 정아영 (울산대학교 의과대학 서울아산병원 영상의학과) ;
  • 이진성 (울산대학교 의과대학 서울아산병원 영상의학과) ;
  • 조영아 (울산대학교 의과대학 서울아산병원 영상의학과)
  • Received : 2022.05.31
  • Accepted : 2022.09.15
  • Published : 2022.09.01
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Abstract

The Kasai portoenterostomy is the first-line treatment for the restoration of the flow of bile to the small intestine in patients with biliary atresia. Various complications can occur after Kasai portoenterostomy, including ascending cholangitis, biliary cirrhosis, and portal hypertension. Of these potential complications, ascending cholangitis in the most common. In cases of patients having uncontrolled complications due to progressive liver cirrhosis, portal hypertension, or progressive hyperbilirubinemia, liver transplantation is the indicated as treatment plan. Lifelong follow-up, particularly involving imaging studies, is important for the identification of various complications arising from biliary atresia after Kasai portoenterostomy. Additionally, imaging studies play a crucial role in the evaluation of potential liver donors and recipients. US is a key imaging modality utilized in the management of patients who undergo Kasai portoenterostomy, while CT and MRI are imperative to obtaining an accurate diagnosis.

신생아 황달의 주요 원인인 담도폐쇄증은 Kasai portoenterostomy가 기본적인 치료 술식이다. 수술 이후 다양한 합병증이 발생할 수 있는데 portoenterostomy를 통해 발생하는 상행성 담도염이 가장 흔하다. 성공적인 Kasai portoenterostomy 후에도 간 섬유화가 진행할 수 있어 이로 인한 간경화, 문맥 고혈압으로 인한 합병증이 많은 경우에서 발생하게 된다. 합병증이 조절되지 않거나 진행성 고빌리루빈혈증이 있는 경우 간이식을 시행하게 된다. Kasai portoenterostomy 이후 합병증 확인 및 장기 생존 환자의 추적 검사로 다양한 영상 진단이 주요 역할을 하고 있다. 또한 간이식이 필요한 경우 이식 전후로 공여자 및 수혜자 모두에서 수술 금기 확인 및 합병증 조기 발견을 위해 영상 검사들이 중요한 역할을 한다. 초음파 검사가 추적 관찰에 가장 먼저 사용되는 유용한 검사이며 추가적으로 CT 및 MRI를 통해 진단에 도움을 받을 수 있다.

Keywords

References

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