Abstract | PURPOSE: Cholangiography is often crucial for establishing the definitive diagnosis in infants with prolonged jaundice. Here, we describe our protocol of using the two-hole laparoscopic technique and discuss its benefits. METHODS: 144 consecutive patients with suspected biliary atresia were included in this retrospective study. A 5-mm umbilical port is introduced for a 30 degrees laparoscope. An additional 5-mm trocar was inserted at right subcostal incision. A liver biopsy was performed first if needed. The fundus of gallbladder was then exteriorized through the incision of the working port after pneumoperitoneum was released and a catheter is inserted into the gallbladder for cholangiography. RESULTS: The average duration of operation was 34 min (range 20-55 min). Laparoscopic cholangiography failed in 21 cases (14.6%) where atrophic gallbladder was found and BA was confirmed by subsequent laparotomy. For the remaining 123 cases, biliary atresia were diagnosed in 88 (71.5%), biliary hypoplasia in 14 (11.4%), and cholestasis in 21 (17.1%), respectively. There was no bleeding or any other complications intraoperatively. CONCLUSION: The technique of laparoscopic cholecystocholangiography is simple, safe and efficient. It can provide an accurate diagnosis. Furthermore, for patients without biliary atresia, unnecessary laparotomy can be avoided.
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Authors | Liuming Huang, Wei Wang, Gang Liu, Jun Jia, Shuqin Wang, Baofu Liu, Jun Zhang, Shuli Liu, Wenying Hou, Long Li |
Journal | Pediatric surgery international
(Pediatr Surg Int)
Vol. 26
Issue 7
Pg. 711-5
(Jul 2010)
ISSN: 1437-9813 [Electronic] Germany |
PMID | 20461389
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Biliary Atresia
(complications, diagnosis)
- Cholangiography
(methods)
- Cholecystography
(methods)
- Female
- Gallbladder
(surgery)
- Gastric Fundus
(surgery)
- Humans
- Infant
- Infant, Newborn
- Jaundice
(etiology)
- Jaundice, Neonatal
(etiology)
- Laparoscopy
(methods)
- Male
- Retrospective Studies
- Sensitivity and Specificity
- Treatment Outcome
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