Research Information System
Turkish Journal of Gastroenterology, vol.36, no.11, pp.763-769, 2025 (SCI-Expanded, Scopus, TRDizin)
Background/Aims: The aim of this study was to develop a diagnostic scoring model to predict the need for intraoperative cholangiogra- phy in patients with neonatal cholestasis suspected of having biliary atresia (BA) and to aid in the early diagnosis of BA. Materials and Methods: Data from 70 patients with neonatal cholestasis who underwent intraoperative cholangiography with a prelimi- nary diagnosis of BA between 2019 and 2024 were retrospectively reviewed. Data from patients with and without BA were compared. Thescoring was based on 3 parameters: acholic stool observed clinically on inspection, findings suggestive of BA on ultrasound, and elevated gamma-glutamyl transferase (GGT) levels. The best GGT cut-off point for the diagnosis of BA was determined by receiver operating characteristic analysis. The diagnostic success of the scoring model for BA was statistically evaluated. Results: There were no significant differences in age and gender between BA and non-BA groups. Gamma-glutamyl transferase levels were elevated in all patients. Acholic stools were present in 98% of BA patients. Ultrasound findings suggestive of BA were present in 88.5% of patients with BA. The authors found the best GGT cut-off value for the diagnosis of BA to be ≥366 (73% sensitivity, 77.8% specificity). In the scoring model the authors developed, the presence of 2 parameters provided diagnostic success with high sensitivity (98%) and specificity (83.3%). Conclusion: The study provides a reliable and sensitive diagnostic criterion to determine the need for intraoperative cholangiography in infants with neonatal cholestasis. These data should be validated in larger prospective case series