Ultrasound-guided percutaneous cholecystostomy for acute neonatal biliary obstruction.
Use of a percutaneously-inserted cholecystostomy drainage tube is an effective therapeutic option for acute hyperbilirubinemia in severely-ill adult patients, but to our knowledge has not been previously reported in infants. We describe an infant who developed acute extrahepatic biliary tract obstruction with marked conjugated (direct) hyperbilirubinemia, and who was determined to be an unsuitable surgical candidate. Ultrasound-guided percutaneous cholecystostomy was performed and resulted in prompt, significant, and sustained decline in serum bilirubin levels. Potential risks and benefits, as well as suggested indications for the procedure are discussed.
Helin
Radley
R
Department of Pediatrics, University of Illinois Medical Center, Chicago, IL 60612, USA. rhelin1@uic.edu
Bhat
Rama
R
Rao
Bhaskara
B
D001663:Bilirubin / Q000097:blood; D002763:Cholecystectomy / Q000379:methods*; D001651:Cholestasis, Extrahepatic / Q000601:surgery*; D006554:Hernia, Umbilical; D006801:Humans; D007231:Infant, Newborn; D041781:Jaundice, Obstructive / Q000601:surgery*; D016343:Monitoring, Intraoperative; D016896:Treatment Outcome
D001663:Bilirubin