Long-term external catheter biliary drainage for recurrent cholangitis after hepatoportoenterostomy

An infant developed relapsing cholangitis following hepatoportoenterostomy for extrahepatic biliary atresia. The source of recurrent infection seemed to be an intrahepatic cyst. Short-term percutaneous cholangio-drainage of such cysts, resulting in eradication of infection, has been described. However, this child required continuous drainage because of persistence of infection in the reaccumulating bile. The insertion of a nephrostomy catheter and use of enterostomal appliances have allowed continuous uneventful biliary drainage for 15 months.