J Korean Assoc Pediatr Surg.  2002 Dec;8(2):156-160.

Diagnostic Laparoscopy in Infantile Cholestatic Jaundice

Affiliations
  • 1Department of Surgery, Catholic University Medical College, Seoul, Korea.

Abstract

When jaundice persists for more than 14 days postnatally, the early diagnosis of surgical jaundice is important for the prognosis in extrahepatic biliary atresia after draining procedure. The role of diagnostic laparoscopy to differenctiate medical causes of jaundice from biliary atresia is evaluated in this report. Four patients with prolonged jaundice have been included in this study. When the gallbladder was not visualized we proceeded to laparotomy. In patients with enlarged gallbladder visualized at laparoscopy, laparoscopic guided cholangiogram was performed, and laparoscopic liver biopsy was done for those who had a patent biliary tree. Two patients had small atretic gallbladder and underwent a Kasai hepato-portoenterostomy. One patients showed a patent gallbladder and common bile duct with atresia of the common hepatic and intrahepatic ducts, and they underwent a Kasai hepatic-portoenterostomy. One patient showed an enlarged gallbladder and laparoscopic-guided cholangiogram were normal. Laparoscopic liver biopsy was performed. There were no complications. Laparoscopy wth laparoscopic-guided cholangiogram may be a valuable method in accurate and earlier diagnosis in an infant with prolonged jaundice.

Keyword

Infantile cholestatic jaundice; Neonatal hepatitis; Biliary atresia; Laparoscopy

MeSH Terms

Biliary Atresia
Biliary Tract
Biopsy
Common Bile Duct
Diagnosis
Early Diagnosis
Gallbladder
Humans
Infant
Jaundice
Jaundice, Obstructive*
Laparoscopy*
Laparotomy
Liver
Prognosis
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