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Percutaneous Transhepatic Biliary Interventions in Benign Diseases of Children

Year 2015, Volume: 40 Issue: 2, 298 - 305, 28.09.2015
https://doi.org/10.17826/cutf.63381

Abstract

Purpose: Percutaneous transhepatic biliary interventions are performed safely and effectively in adults. There is less experience of these interventions in benign diseases of children. We aimed to evaluate the safety and efficacy of percutaneous biliary interventions in benign diseases of children. Materials and Methods: In this retrospective study, percutaneous biliary interventions were performed in fifteen children with a mean age of 10.2 years (range 14 days-14 years). Patients presented with jaundice (n=5) and/or cholangitis (n=10). Percutaneous transhepatic biliary drainage (PTBD) performed in 10 patients, PTBD plus balloon dilation in 3, percutaneous cholecystostomy (PC) in 1, PTBD following PC in 1. Results: All procedures were technically successful. No procedure-related mortality occurred in patients. Serum bilirubin levels returned to normal or near normal in ten of twelve cases. Preexisting cholangitis and acute cholecystitis resolved in all patients. Six patients underwent surgery following percutaneous management. Nine patients cured primarily with percutaneous interventions with no further treatment. Conclusion: Percutaneous biliary interventions can be performed effectively in benign diseases of children. It can be performed either as a primary treatment modality or as a bridge prior to surgery. In most of cases, percutaneous treatment is sufficient and unnecessary surgery is prevented.

References

  • Ring EJ, Oleaga JA, Freiman DB, et al: Therapeutic applications of catheter cholangiography. Radiology. 1978;128:333-8.
  • Rossi P, Bezzi M, Rossi M, et al: Metallic stents in malignant biliary obstruction: Results of a multicenter European study of 240 patients. J Vasc Intervent Radiol. 1994;5:279–85.
  • İnal M, Aksungur E, Akgül E, et al: Percutaneous
  • placement of metallic stents in malignant biliary obstruction: one-stage or two-stage procedure? Pre- dilate or not? Cardiovasc Intervent Radiol. İnal M, Akgül E, Aksungur E, et al: Percutaneous placement of biliary metallic stents in patients with malignant hilar obstruction: unilobar versus bilobar drainage. J Vasc Interv Radiol. 2003;14:1409-16.
  • Teplick SK, Wolferth CC, Hayes MF, et al: Balloon dilation of benign postsurgical biliary-enteric anastomotic strictures. Gastrointestinal Radiol. 1987;7:307-10.
  • Akhan O, Akinci D, Ozmen MN: Percutaneous cholecystostomy. Eur J Radiol. 2002;43:229-36.
  • İnal M, Akgul E, Aksungur E, et al: Percutaneous
  • placement of self-expandable uncovered metallic stents in malignant biliary obstruction: complications, follow-up and reintervention in 154 patients. Acta Radiol. 2003;44:139-46.
  • Roebuck DJ, Stanley P: External and internal- external biliary drainage in children with malignant obstructive jaundice. Pediatr Radiol. 2000;30:659-64.
  • Akinci D, Gumus B, Ozkan OS, et al: Percutaneous management of tumoral biliary obstruction in children. Pediatr Radiol. 2007;37:975-80.
  • Lorenz JM, Denison G, Funaki B, et al: Balloon dilation of biliary-enteric strictures in children. Am J Radiol. 2005;184:151-5.
  • Todani T, Watanabe Y, Narusue M, et al: Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg. 1977;134:263-9.
  • Costamagna G, Familiari P, Tringali A, et al: Multidisciplinary approach to benign biliary strictures. Curr Treat Options Gastroenterol. 2007;10:90-101.
  • Holcomb GW, O’Neil JA, Holcomb GW: Cholecystitis, cholelithiasis and common duct stenosis in children and adolescents. Ann Surg. 1980;191:626-35.
  • Wiseman K, Buczkowski AK, Chung SW, et al: Epidemiology, presentation, diagnosis, and outcomes of choledochal cysts in adults in an urban environment. Am J Surg. 2005;189:527-31.
  • Schwarzenberg SJ, Sharp HL, Payne WD, et al: Biliary stricture in living-related donor liver transplantation: management with balloon dilation. Pediatr Transplant. 2002;6:132-5.
  • Gharbi HA, Hassine W, Brauner MW, et al: Ultrasound examination of the hydatid liver. Radiology. 1981;139:459-63.
  • İnal M, Soyupak S, Akgül E, et al: Percutaneous transhepatic endobiliary drainage of hepatic hydatid cyst with rupture into the biliary system: unusual route for drainage. Cardiovasc Intervent Radiol.
  • Parsak CK, Demiryürek HH, İnal M, et al: Alveolar
  • hydatid disease: imaging findings and surgical
  • approach. Acta Chir Belg. 2007;107:572-7.
  • Blais C, Duperval R: Biliary pseudolithiasis in a child associated with 2 days of ceftriaxone therapy. Pediatr Radiol 1994;24:218-9.

Çocukluk Çağı Benign Hastalıklarında Perkütan Transhepatik Biliyer Girişimler

Year 2015, Volume: 40 Issue: 2, 298 - 305, 28.09.2015
https://doi.org/10.17826/cutf.63381

Abstract

Amaç: Perkütan transhepatik biliyer girişimler erişkinlerde güvenli ve etkili bir biçimde uygulanmaktadır. Çocukluk çağı benign hastalıklarında kullanımı konusundaki deneyimler daha azdır. Çalışmamızda çocukluk çağı benign hastalıklarında yöntemin güvenilirliği ve etkinliği araştırılmıştır. Materyal ve Metod: Bu retrospektif çalışmada, ortalama yaşı 10.2 (ranj 14 gün-14 yaş) olan 15 çocuğa perkütan biliyer girişim uygulanmıştır. Beş hasta sarılık,10 hasta kolanjit yakınmaları ile başvurmuştur. Perkütan transhepatik biliyer drenaj (PTBD) 10 hastaya, PTBD ve balon dilatasyon 3 hastaya, perkütan kolesistomi (PK) 1 hastaya, PTBD yi takiben PK bir hastaya uygulanmıştır. Bulgular: Uygulanan bütün işlemler teknik olarak başarıyla sonuçlandırılmıştır. İşleme bağlı mortalite olmamıştır. Oniki hastada serum bilüribin seviyeleri normal veya normale yakın seviyelere dönmüştür. İşlemden önce mevcut kolanjit ve akut kolesistit iyileşmiştir. Altı hastaya perkütan işlem sonrası cerrahi uygulanması gerekmiştir. Dokuz hasta ileri tedaviye ihtiyaç duyulmaksızın primer olarak perkütan girişimle iyileşmiştir. Sonuç: Perkütan biliyer girişimler çocukluk çağı benign hastalıklarında etkili bir biçimde uygulanabilir. Primer tedavi yöntemi olarak veya cerrahi öncesi kullanılabilir. Birçok olguda perkütan tedavi yeterli olmuş ve gereksiz cerrahi önlenmiştir.

References

  • Ring EJ, Oleaga JA, Freiman DB, et al: Therapeutic applications of catheter cholangiography. Radiology. 1978;128:333-8.
  • Rossi P, Bezzi M, Rossi M, et al: Metallic stents in malignant biliary obstruction: Results of a multicenter European study of 240 patients. J Vasc Intervent Radiol. 1994;5:279–85.
  • İnal M, Aksungur E, Akgül E, et al: Percutaneous
  • placement of metallic stents in malignant biliary obstruction: one-stage or two-stage procedure? Pre- dilate or not? Cardiovasc Intervent Radiol. İnal M, Akgül E, Aksungur E, et al: Percutaneous placement of biliary metallic stents in patients with malignant hilar obstruction: unilobar versus bilobar drainage. J Vasc Interv Radiol. 2003;14:1409-16.
  • Teplick SK, Wolferth CC, Hayes MF, et al: Balloon dilation of benign postsurgical biliary-enteric anastomotic strictures. Gastrointestinal Radiol. 1987;7:307-10.
  • Akhan O, Akinci D, Ozmen MN: Percutaneous cholecystostomy. Eur J Radiol. 2002;43:229-36.
  • İnal M, Akgul E, Aksungur E, et al: Percutaneous
  • placement of self-expandable uncovered metallic stents in malignant biliary obstruction: complications, follow-up and reintervention in 154 patients. Acta Radiol. 2003;44:139-46.
  • Roebuck DJ, Stanley P: External and internal- external biliary drainage in children with malignant obstructive jaundice. Pediatr Radiol. 2000;30:659-64.
  • Akinci D, Gumus B, Ozkan OS, et al: Percutaneous management of tumoral biliary obstruction in children. Pediatr Radiol. 2007;37:975-80.
  • Lorenz JM, Denison G, Funaki B, et al: Balloon dilation of biliary-enteric strictures in children. Am J Radiol. 2005;184:151-5.
  • Todani T, Watanabe Y, Narusue M, et al: Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg. 1977;134:263-9.
  • Costamagna G, Familiari P, Tringali A, et al: Multidisciplinary approach to benign biliary strictures. Curr Treat Options Gastroenterol. 2007;10:90-101.
  • Holcomb GW, O’Neil JA, Holcomb GW: Cholecystitis, cholelithiasis and common duct stenosis in children and adolescents. Ann Surg. 1980;191:626-35.
  • Wiseman K, Buczkowski AK, Chung SW, et al: Epidemiology, presentation, diagnosis, and outcomes of choledochal cysts in adults in an urban environment. Am J Surg. 2005;189:527-31.
  • Schwarzenberg SJ, Sharp HL, Payne WD, et al: Biliary stricture in living-related donor liver transplantation: management with balloon dilation. Pediatr Transplant. 2002;6:132-5.
  • Gharbi HA, Hassine W, Brauner MW, et al: Ultrasound examination of the hydatid liver. Radiology. 1981;139:459-63.
  • İnal M, Soyupak S, Akgül E, et al: Percutaneous transhepatic endobiliary drainage of hepatic hydatid cyst with rupture into the biliary system: unusual route for drainage. Cardiovasc Intervent Radiol.
  • Parsak CK, Demiryürek HH, İnal M, et al: Alveolar
  • hydatid disease: imaging findings and surgical
  • approach. Acta Chir Belg. 2007;107:572-7.
  • Blais C, Duperval R: Biliary pseudolithiasis in a child associated with 2 days of ceftriaxone therapy. Pediatr Radiol 1994;24:218-9.
There are 22 citations in total.

Details

Primary Language English
Journal Section Research
Authors

Medih Çeliktaş This is me

Publication Date September 28, 2015
Published in Issue Year 2015 Volume: 40 Issue: 2

Cite

MLA Çeliktaş, Medih. “Percutaneous Transhepatic Biliary Interventions in Benign Diseases of Children”. Cukurova Medical Journal, vol. 40, no. 2, 2015, pp. 298-05, doi:10.17826/cutf.63381.