Bollu Bapesh K, Dawrant Michael J, Thacker Kunal, Thomas Gordon, Chenapragadda Murthy, Gaskin Kevin, Shun Albert
Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, Australia.
Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, Australia.
J Pediatr Surg. 2016 Dec;51(12):2119-2122. doi: 10.1016/j.jpedsurg.2016.09.053. Epub 2016 Sep 20.
Inspissated bile syndrome (IBS) is a rare cause of obstructive jaundice in neonates and infants with several treatment options reported. We present our experience with the use of minimally invasive ultrasound-guided percutaneous cholecystostomy drain catheter placement with ongoing saline lavage in neonates and infants.
Retrospective chart review of patients treated with percutaneous cholecystostomy, from February 2010 till June 2015. We reviewed the technical and clinical success along with complications of the procedure.
There were 6 patients, mean age 17weeks (range 4-40). Most had significant risk factors for IBS presenting with biliary obstruction. A total of 7 procedures performed on the 6 patients, with a technical success rate of 6/7. One patient required cannulation of the intrahepatic biliary system. Drains were flushed for a median of 26days (10-70). Clinical success was achieved in all patients. 3 had displacement of the drain, one of which required re-insertion. Another developed a small sub-hepatic collection post procedure with pyrexia. On long term follow up one was found to have a forme fruste choledochal cyst.
Centers with suitable interventional radiology services ultrasound-guided percutaneous cholecystostomy drain catheter placement with ongoing saline lavage is a safe and effective minimally invasive treatment for IBS in neonates and infants.
浓缩胆汁综合征（IBS）是新生儿和婴儿梗阻性黄疸的罕见病因，已有多种治疗方案的报道。我们介绍了在新生儿和婴儿中使用微创超声引导经皮胆囊造瘘引流导管置入并持续进行盐水灌洗的经验。
对2010年2月至2015年6月期间接受经皮胆囊造瘘术治疗的患者进行回顾性病历审查。我们回顾了该手术的技术和临床成功率以及并发症情况。
共有6例患者，平均年龄17周（范围4 - 40周）。大多数患者有IBS伴胆道梗阻的显著危险因素。对这6例患者共进行了7次手术，技术成功率为6/7。1例患者需要肝内胆管系统插管。引流管冲洗的中位时间为26天（10 - 70天）。所有患者均取得临床成功。3例患者出现引流管移位，其中1例需要重新插入。另1例患者术后出现小的肝下积液并伴有发热。长期随访发现1例患者有胆总管囊肿的不完全型。
具备合适介入放射学服务的中心，超声引导经皮胆囊造瘘引流导管置入并持续进行盐水灌洗是治疗新生儿和婴儿IBS的一种安全有效的微创治疗方法。
