Diagnosis and treatment of intrahepatic biliary cysts in children with biliary atresia after portoenterostomy

Abstract

Objective To summarize the experience of diagnosis and treatment of intrahepatic biliary cysts(IBCs)in children with biliary atresia after portoenterostomy in order to analyze the influence of IBCs on the prognosis of patients with biliary atresia(BA).Methods The patients with BA who underwent portoenterostomy were followed up from June 1998 to March 2008.Ultrasonography showed cystic dilatation of intrahepatic biliary system in 8 cases.In the abovementioned cases,three were diagnosed by MRI and six by CT enhancement scanning.All the patients had symptoms of cholangitis postoperatively.Five of them who underwent PTCD and 3 underwent operation of cysticjejunum anastomosis.Results Jaundice disappeared or alleviated in the 3 patients who underwent a second operation.The patient only accepted biliary drainage by FTCD had persistent intrahepatic biliary cyst.Conclusions Regular ultrasonography examination is needed in patients with recurrent cholangitis so as to get the IBCs diagnosed in time.Once the existence of IBCs is proved by imaging examination,active treatment should be adopted immediately according to patients' clinical manifestations.PTCD can not be kept for a long time,as its function is temporary biliary drainage.Cystic-jejunum anastomosis is an effective operation for patients with IECs after Kasars operation. Key words: Bile duct diseases; Biliary atresia