Hiroaki Fukuzawa1,2, Naoto Urushihara3, Chisato Miyakoshi4, Keisuke Kajihara5, Insu Kawahara6,5, Kaori Isono5, Yoshitomo Samejima5, Shizu Miura5, Kotaro Uemura5, Keiichi Morita6,5, Makoto Nakao5, Akiko Yokoi5, Koji Fukumoto3, Masaya Yamoto3, Kosaku Maeda6,5. 1. Division of Pediatric Surgery, Department of Surgery, Kobe University School of Medicine, Kobe, Japan. fukuzawa_kch@hp.pref.hyogo.jp. 2. Department of Pediatric Surgery, Kobe Children's Hospital, Chuou-ku minatojimaminami 1-6-7, Kobe, 650-0047, Japan. fukuzawa_kch@hp.pref.hyogo.jp. 3. Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan. 4. Department of Pediatrics, Kobe City Medical Center General Hospital, Kobe, Japan. 5. Department of Pediatric Surgery, Kobe Children's Hospital, Chuou-ku minatojimaminami 1-6-7, Kobe, 650-0047, Japan. 6. Division of Pediatric Surgery, Department of Surgery, Kobe University School of Medicine, Kobe, Japan.
Abstract
PURPOSE: This study aimed to investigate the clinical features and risk factors of bile duct perforation in pediatric congenital biliary dilatation (CBD) patients. METHODS: CBD patients, whose initial symptom was abdominal pain, were enrolled in this study and were divided into perforated and non-perforated groups. The clinical features of the perforated group were investigated. Moreover, the age at operation, sex, and morphologic features of the extrahepatic bile duct were compared between the groups. RESULTS: Fifteen cases of bile duct perforation (10.4%) were identified among the 144 CBD patients who had abdominal pain. Majority of bile duct perforation occurred in patients aged < 4 years. The median duration from onset of abdominal pain to bile duct perforation was 6 (4-14) days. Age at onset [< 4 years old; P = 0.02, OR 13.9, (1.663, 115.3)], shape of extrahepatic bile duct [non-cystic type; P = 0.009, OR 8.36, (1.683, 41.5)], and dilatation of the common channel [P = 0.02, OR 13.6, (1.651, 111.5)] were risk factors of bile duct perforation. CONCLUSIONS: Emergent bile duct drainage might be planned to prevent bile duct perforation if CBD patients have the abovementioned risk factors and experience persistent abdominal pain lasting for a few days from onset.
PURPOSE: This study aimed to investigate the clinical features and risk factors of bile duct perforation in pediatric congenital biliary dilatation (CBD) patients. METHODS: CBD patients, whose initial symptom was abdominal pain, were enrolled in this study and were divided into perforated and non-perforated groups. The clinical features of the perforated group were investigated. Moreover, the age at operation, sex, and morphologic features of the extrahepatic bile duct were compared between the groups. RESULTS: Fifteen cases of bile duct perforation (10.4%) were identified among the 144 CBD patients who had abdominal pain. Majority of bile duct perforation occurred in patients aged < 4 years. The median duration from onset of abdominal pain to bile duct perforation was 6 (4-14) days. Age at onset [< 4 years old; P = 0.02, OR 13.9, (1.663, 115.3)], shape of extrahepatic bile duct [non-cystic type; P = 0.009, OR 8.36, (1.683, 41.5)], and dilatation of the common channel [P = 0.02, OR 13.6, (1.651, 111.5)] were risk factors of bile duct perforation. CONCLUSIONS: Emergent bile duct drainage might be planned to prevent bile duct perforation if CBD patients have the abovementioned risk factors and experience persistent abdominal pain lasting for a few days from onset.
Entities:
Keywords:
Common channel; Congenital biliary dilatation; Pediatric; Perforation; Risk factor
Authors: J S de Vries; S de Vries; D C Aronson; D K Bosman; E A J Rauws; A Bosma; H A Heij; D J Gouma; T M van Gulik Journal: J Pediatr Surg Date: 2002-11 Impact factor: 2.545