Laparoscopic therapy for infant obstructive jaundice

Abstract

Objective To explore the value of early laparoscopic intervention in infant cholestatic jaundice.Method 56 cholestatic jaundiced infants underwent early laparoscopic biliary tract exploration and cholangiography after two weeks of regular conservative treatments,which failed to decrease bilirubin level significantly.The non-congenital biliary atresia patients with definite preoperative diagnosis received bitiary tract irrigation.Results Correct diagnosis was established in all those 56 patients by laparoscopic procedures.Among those,12 cases were diagnosed as cholestatic syndrome(21%) ,4 cases were diagnosed as congenital bile duct dysplasia(7%),40 cases were diagnosed as biliary atresia(72%).16 cases who were diagnosed as non-congenital biliary atresia recovered after laparoscopic cholecystostomy and biliary tract irrigation.All infants were followed-up for 6 months to 42 months,they were all in good condition and there were no symptom recurrence.Conclusion Early laparoscopic intervention in infant with cholestatic jaundice helps to establish early diagnosis and early correct treatment.For cholestatic syndrome and congenital bile duct dysplasia patients,cholecystostomy and biliary tract irrigation reduces cholestasisinduced liver damage.For biliary atresia patients,this procedure offers an early operation opportunity. Key words: Jaundice,obstruction; Laparoscopy; Biliary atresia; Infant