{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:43:14Z","timestamp":1787010194642,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2009,10,1]],"date-time":"2009-10-01T00:00:00Z","timestamp":1254355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2009,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We investigated the role and safety of endoscopic retrograde cholangiopancreatography (ERCP) in diagnosing biliary atresia (BA) in prolonged neonatal cholestasis, when standard workup was inconclusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>We reviewed notes of 48 cholestatic infants younger than 100 days undergoing ERCP from 1997 to 2007.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Amongst approximately 3300 infants evaluated for liver disease during the study, 224 (6.8%) were diagnosed with BA. Forty\u2010eight children underwent ERCP. Findings at liver biopsy (n = 47) included nonspecific cholestasis (n = 19, 40%), giant\u2010cell hepatitis (n = 12, 26%), \u201clarge bile duct obstruction\u201d (n = 9, 19%) in the presence of pigmented stools, and mixed cholestatic\/hepatitic features (n = 7, 15%). ERCP demonstrated a patent biliary tree in 20 infants (42%). BA was confirmed at exploratory laparotomy in all 3 infants (6%) in whom cannulation failed. The remaining 25 infants (52%) also proceeded to exploratory laparotomy, in which BA was confirmed in 22 (46%). Amongst the 20 children in whom ERCP ruled out BA, 8 (17%) had normal biliary anatomy, whilst 12 (25%) had an abnormal biliary tree, including 6 (12.5%) with neonatal sclerosing cholangitis. After ERCP none developed clinical pancreatitis or peritonitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>ERCP is a safe procedure for diagnosing BA even in the smallest infants with high positive and negative predictive values.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/mpg.0b013e3181a8711f","type":"journal-article","created":{"date-parts":[[2009,9,23]],"date-time":"2009-09-23T09:12:57Z","timestamp":1253697177000},"page":"435-441","source":"Crossref","is-referenced-by-count":75,"title":["Selective Use of Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Biliary Atresia in Infants Younger Than 100 Days"],"prefix":"10.1002","volume":"49","author":[{"given":"Naresh P","family":"Shanmugam","sequence":"first","affiliation":[{"name":"Paediatric Liver Centre UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip 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