Retrospective Analysis Of Causes Of Gallbladder Contraction In Children With Biliary Atresia

Objective: To retrospectively analyze the causes of gallbladder contraction on ultrasound examination in children with biliary atresia(BA).Methods: This article collected 450 cases in Shengjing Hospital Affiliated to China Medical University from January 2003 to November 2019,of which 406 cases were diagnosed by ultrasound examination;67 cases were diagnosed by surgery only,and 25 cases diagnosed by cholangiography,128 cases were diagnosed by surgery and cholangiography.The formation of biliary bypass was found in 42 cases of 153 cases of cholangiography.318 cases underwent ultrasound gallbladder contraction test and 45 cases of 318 cases showed gallbladder contraction after meal.115 cases underwent ultrasound gallbladder contraction test and cholangiography.To retrospectively analyze the results of surgery or cholangiography in children with BA who underwent ultrasound gallbladder contraction test.Fisher’exact test was used to analyze whether the gallbladder contraction and biliary bypass in children with BA were related.The Mann-Whitney test was used to analyze the correlation between the gallbladder contraction and biliary bypass.The Spearman correlation analysis was used to analyze the correlation between the rate of gallbladder contraction and the length,the diameter,the path or the shape of biliary bypass.Results: The gallbladder contraction after feeding in children with BA was related to the formation of biliary bypass(P<0.05).The gallbladder contraction rate at 1h,2h and 3h after feeding was related to the formation of biliary bypass(P<0.05).The gallbladder contraction rate at 1h after feeding was correlated with the diameter of the biliary bypass which is positively correlated with the grade coefficient of 0.683(P<0.05).The study summarizes the influencing factors found in measurement of gallbladder contraction rate and the display of biliary bypass,including:non-standard ultrasound scan of gallbladder,inconsistent cursor mearurement position,or data error in the ultrasound report;incomplete biliary bypass angiography,and most of the biliary bypass were slender and bend shape.Conclusion: Gallbladder contraction is closely related to biliary bypass in children with BA,and the degree of contraction is positively related to the diameter of biliary bypass.Correctly judging gallbladder contraction in children with BA is one of the important factors to avoid the missed diagnosis and misdiagnosis of BA by ultrasound examination,and indirectly improves the diagnosis rate of BA.