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Stenting of the biliary tract in children
C M Kullendorff1, E Arnbjörnsson, W Cwikiel
1Department of Paediatrics, University Hospital Lund, Sweden. carl-magnus.kullendorff@skane.se
Insights
Percutaneous transhepatic biliary drainage (PTBD) offers a safe solution for obstructive jaundice in children when endoscopic methods fail. This minimally invasive procedure provided effective palliation in most cases, demonstrating its utility in pediatric care.
Area of Science:
- Pediatric Gastroenterology
- Interventional Radiology
- Hepatobiliary Surgery
Background:
- Obstructive jaundice in children presents significant management challenges.
- Endoscopic retrograde cholangiopancreatography (ERCP) may not always be feasible or successful in pediatric patients.
- Percutaneous transhepatic biliary drainage (PTBD) is an alternative intervention for biliary decompression.
Observation:
- This study evaluated the technique and outcomes of PTBD in three pediatric patients (ages 8-15) with obstructive jaundice.
- Indications included benign and malignant biliary strictures where endoscopic treatment was not possible.
- Procedures were performed under general anesthesia, utilizing external-internal drainage or endoprosthesis insertion.
Findings:
- No immediate complications were observed following the PTBD procedures.
- PTBD achieved good palliative effects in two of the three patients.
- One patient ultimately required surgical intervention despite PTBD.
Implications:
- Percutaneous transhepatic biliary drainage is a safe and viable option for managing obstructive jaundice in pediatric populations.
- PTBD can provide effective palliation and serves as a crucial alternative when less invasive methods are contraindicated or unsuccessful.
- Further research may explore long-term outcomes and expand indications for PTBD in children.
Abstract:
We report on the technique and results of percutaneous transhepatic biliary drainage (PTBD) in children with obstructive jaundice. Three patients aged 8 - 15 years were treated, two of them for a benign and one for a malignant stricture. Endoscopic treatment was not possible and all the PTBD procedures were done under general anaesthesia. One of the children was treated with external-internal drainage, and the two others by insertion of a plastic endoprosthesis. There were no immediate complications. The PTBD had a good palliative effect in two cases, and in one case surgical treatment was necessary. We conclude that PTBD is a safe modality and that it can be used in children for the relief of obstructive jaundice.