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儿童良性胆道疾病的经皮处理。

Percutaneous management of benign biliary disorders in children.

机构信息

Erciyes University, Medical Faculty, Gevher Nesibe Hospital, Department of Radiology, 38039 Kayseri, Turkey.

出版信息

Diagn Interv Imaging. 2018 Jan;99(1):37-42. doi: 10.1016/j.diii.2017.05.010. Epub 2017 Jun 21.

Abstract

PURPOSE

The goal of this study was to analyze the outcomes of percutaneous transhepatic management of benign biliary disorders in pediatric patients.

MATERIALS AND METHODS

This study included 11 pediatric patients who underwent percutaneous transhepatic biliary interventional procedures between September 2007 and December 2016. There were 3 males and 8 females with a mean age of 9.6±5.4 (SD)years (range: 2-17years). Technical details, complications and outcome of the procedures were evaluated.

RESULTS

The underlying pathologies were bile duct stones (n=2), bile leakage (n=4), choledochal cyst (n=3) and benign biliary stricture (n=2). The therapeutic interventional procedures were as follows; percutaneous stone removal in patients with bile duct stones, external biliary drainage in patients with choledochal cyst, bile diversion by internal-external percutaneous biliary drainage (IE-PBD) in patients with bile leakage, plastic stent placement, IE-PBD with balloon dilatation in patients with benign biliary stricture. The procedures were successful in all patients technically and clinically. One patient experienced intermittent fever.

CONCLUSION

Percutaneous transhepatic biliary interventional procedure is an effective and safe approach for the treatment of pediatric patients with bile duct stones, bile leakage, symptomatic choledochal cyst and benign biliary stricture when endoscopic procedure is unavailable or fails.

摘要

目的

本研究旨在分析经皮经肝途径治疗小儿良性胆道疾病的疗效。

材料与方法

本研究纳入了 2007 年 9 月至 2016 年 12 月期间行经皮经肝胆道介入治疗的 11 例小儿患者。其中男 3 例,女 8 例,平均年龄 9.6±5.4(SD)岁(范围:2-17 岁)。评估了手术技术细节、并发症和治疗结果。

结果

基础病变包括胆管结石(n=2)、胆漏(n=4)、胆总管囊肿(n=3)和良性胆管狭窄(n=2)。治疗性介入操作包括:胆管结石患者行经皮经肝取石术,胆总管囊肿患者行外引流术,胆漏患者行经皮经肝胆内外引流术(IE-PBD),良性胆管狭窄患者行塑料支架置入术、IE-PBD 联合球囊扩张术。所有患者在技术和临床方面均获得成功。1 例患者出现间歇性发热。

结论

当内镜治疗不可行或失败时,经皮经肝胆道介入治疗是治疗小儿胆管结石、胆漏、有症状的胆总管囊肿和良性胆管狭窄的有效且安全的方法。

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