Related Experiment Video
Updated: Dec 24, 2025
Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
Published on: May 2, 2025
Total laparoscopic management of spontaneous biliary perforation
Lawrence Jun Leung1, Marc James Henry Vecchio2, Ajay Rana3
1Kaiser Permanente San Francisco, 2425 Geary Blvd, San Francisco, CA, 94115, USA. lawrence.j.leung@kp.org.
Insights
Spontaneous biliary perforation in children is rare. This study details the first successful minimally invasive laparoscopic treatment for pediatric spontaneous biliary perforation, avoiding gallbladder removal.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Minimally invasive procedures
Background:
- Spontaneous biliary perforation (SBP) in children is a rare condition.
- Historically, surgical repair and cholecystectomy via laparotomy were standard treatments.
- Recent trends favor conservative management with cholecystostomy and drainage.
Observation:
- A pediatric patient presented with spontaneous biliary perforation.
- The case involved a rare presentation of SBP in a young patient.
- Previous management strategies involved open surgery.
Findings:
- This report details the first successful conservative management of pediatric SBP.
- The treatment utilized an exclusively laparoscopic approach.
- Cholecystectomy was successfully avoided in this minimally invasive procedure.
Implications:
- This laparoscopic approach offers a less invasive alternative for SBP management in children.
- Avoiding cholecystectomy may lead to reduced morbidity and faster recovery.
- This case expands the options for conservative treatment of pediatric SBP.
Abstract:
Spontaneous biliary perforation (SBP) in pediatrics is rare and historically has been treated with laparotomy for attempted repair and cholecystectomy. In recent years, management has evolved into a conservative approach, opting for cholecystostomy and peritoneal drainage over cholecystectomy. In this case, we report the first successful conservative management of SBP using an exclusively laparoscopic approach without cholecystectomy in a pediatric patient.
