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Laparoscopic cholecystocholangiography for diagnosis of prolonged jaundice in infants, experience of 144 cases

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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° 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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Acknowledgments

This study was supported by grants from National Science and Technology Infrastructure Program, 11th five-year plan, NO 2006BAI05A06.

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Authors and Affiliations

  1. Department of Pediatric Surgery, BaYi Children’s Hospital, Beijing Military Region General Hospital, Beijing, 100700, China

    Liuming Huang, Wei Wang & Gang Liu

  2. Department of Pediatric Surgery, The First Hospital, Peking University, Beijing, 100034, China

    Jun Jia, Shuqin Wang & Baofu Liu

  3. Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, 100020, China

    Jun Zhang, Shuli Liu, Wenying Hou & Long Li

Authors
  1. Liuming Huang
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  2. Wei Wang
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  3. Gang Liu
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  4. Jun Jia
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  5. Shuqin Wang
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  6. Baofu Liu
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  7. Jun Zhang
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  8. Shuli Liu
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  9. Wenying Hou
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  10. Long Li
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Corresponding author

Correspondence to Long Li.

Additional information

L. Huang and W. Wang contributed equally to this work.

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Huang, L., Wang, W., Liu, G. et al. Laparoscopic cholecystocholangiography for diagnosis of prolonged jaundice in infants, experience of 144 cases. Pediatr Surg Int 26, 711–715 (2010). https://doi.org/10.1007/s00383-010-2598-1

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  • DOI: https://doi.org/10.1007/s00383-010-2598-1

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