One-stage laparoscopic surgery for inspissated bile syndrome: case report and review of surgical techniques

Abstract

Inspissated bile syndrome in a 6 week old boy was unresponsive to oral ursodesoxycholic acid. Intraoperative cholangiography revealed complete obstruction of the common bile duct. Therefore, the gallbladder fundus was pulled out through a laparoscopy port site and sutured to the fascia. A catheter was positioned into the infundibulum for irrigation with ursodesoxycholic acid. At day 8 complete resolution of the plug and free passage of contrast medium into the duodenum was documented radiologically. The catheter was removed, skin closed spontaneously without a second surgery for closure of the gall bladder.

Percutaneous Transhepatic Biliary Drainage in a Two-Month-Old Infant with Inspissated Bile Syndrome

“… 15 In some medical trials, use of UDCA alone to dissolve the bile sludge failed to improve biochemical test results, and ultimately, surgery was required. 7 16 Surgical therapy is normally only needed when the extrahepatic bile ducts are dilated to more than 3 mm. Among the various surgical interventions, percutaneous transhepatic cholangiography is difficult in infants because of the small size of the intrahepatic gall ducts.…”

Use of Omega-3 Polyunsaturated Fatty Acids to Treat Inspissated Bile Syndrome: A Case Report

“…In addition, the pathology findings, which suggested biliary atresia, may have reflected long-term biliary duct obstruction. Some medical trials with UDCA alone to dissolve the bile sludge had failed to improve biochemical tests and ultimately required a surgical procedure [45]. …”

“…This inspissation and precipitation of bile and mucus within the bile ducts is usually caused by blood transfusion, prolonged parenteral nutrition, or diuretics [3]. Treatment of IBS generally involves a surgical procedure such as percutaneous transhepatic cholangiography or laparoscopically aided cholecystostomy with irrigation of the common bile duct using normal saline or a mucolytic agent [45]. However, these procedures are invasive, difficult, and frequently accompanied by postoperative complications in infants.…”

Inspissated bile syndrome: A rare cause of neonatal cholestasis

“…2 Surgical intervention is indicated when the bile duct is dilated to >3 mm with persistent jaundice. 2,3 Berger et al described their clinical experience of successfully treating a 6-week-old infant with IBS via laparoscope-aided cholecystostomy with biliary duct lavage. 3…”

“…2,3 Berger et al described their clinical experience of successfully treating a 6-week-old infant with IBS via laparoscope-aided cholecystostomy with biliary duct lavage. 3…”