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Modified laparoscopic external biliary diversion for benign recurrent intrahepatic cholestasis in obese adolescents

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Abstract

Definitive medical treatment for benign recurrent intrahepatic cholestasis (BRIC) is not available and the significance of surgical treatment is a matter of debate. It has been postulated that BRIC may progress to progressive familial intrahepatic cholestasis (PFIC), which leads to liver insufficiency and cirrhosis. External biliary diversion represents an option for both conditions and we recently introduced a new laparoscopic technique for infants with PFIC. However, limited umbilical incision may interfere with creating a jejunal conduit by infraumbilical exteriorisation, in particular in obese adolescents. Therefore, we modified our technique by exteriorising a small bowel loop via the right midabdominal trocar incision at the position of the jejunostomy. The technique was used in a 17-year-old obese patient with BRIC. This is the first report on a patient with BRIC undergoing laparoscopic external biliary diversion.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany

    Martin L. Metzelder, Claus Petersen & Benno M. Ure

  2. Department of Nephrology and Metabolic Disorders, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany

    Michael Melter

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  1. Martin L. Metzelder
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  2. Claus Petersen
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  3. Michael Melter
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  4. Benno M. Ure
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Correspondence to Martin L. Metzelder.

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Metzelder, M.L., Petersen, C., Melter, M. et al. Modified laparoscopic external biliary diversion for benign recurrent intrahepatic cholestasis in obese adolescents. Ped Surgery Int 22, 551–553 (2006). https://doi.org/10.1007/s00383-006-1683-y

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  • DOI: https://doi.org/10.1007/s00383-006-1683-y

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