Trattamento videoassistito dell'atresia delle vie biliari.

Translated title of the contribution: Video-assisted treatment for biliary atresia

M. Lima, T. Gargano, L. De Biagi, G. Ruggeri, M. Libri, E. Lopci, N. Salfi, R. Sciutti, M. T. Cecini, V. Landuzzi

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The surgical treatment of biliary atresia is still a great challenge for pediatric surgeons. Kasai's operation usually needs a wide, painful, muscle-cutting laparotomies that quite often are followed by pain and peritoneal adhesion. These possible complications may disturb the post-operative course and humper liver transplantation. Advancements in minimally invasive surgery have allowed even the most complex procedures to be approached using these techniques. METHODS: The authors present a case of successful Roux-en-Y laparoscopic portoenterostomy for the treatment of biliary atresia. We report a case of a 3-month-old patient with biliary atresia who weighted Kg 5,300 at the operation. The patient was placed in supine position. The procedure was performed with 4 trocars of 3 mm and 1 of 10 mm. The umbilical site was used for extracorporeal Roux-en-Y enteroenterostomy. CO2 was insufflated at a pressure of 8 mmHg and a flow of 0.5 L/min. A drain was placed through the lower trocar site with the tip near the anastomosis. RESULTS: The procedure was free of neither intraoperative nor post-operative complications. Feeding by nasogastric tube was started after 2 days. Total oral feeding was possible after 8 days. CONCLUSION: Laparoscopic approach to perform Kasai's operation is technically feasible and thanks to a magnified vision, it allows to abtain a good visualization of the portal structures with an adequate retraction of the liver. This procedure can avoid or decrease the post-operative complications such as pain, breathing difficulty, adhesions and resulting in very small scars. Anyway laparoscopic Kasaiportoenterostomy should be done by a surgeon with a good experience in laparoscopic hand-suturing and neonatal experience and with the support of an experienced in neonatal and infantile videosurgery anaesthesiologist.

Translated title of the contributionVideo-assisted treatment for biliary atresia
Original languageItalian
Pages (from-to)212-217
Number of pages6
JournalPediatria Medica e Chirurgica
Volume29
Issue number4
Publication statusPublished - Jul 2007

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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