title: Laparoscopic cholecystocholangiography for diagnosis of prolonged jaundice in infants, experience of 144 cases.
abstract: OBJECTIVE
  Cholangiography is often crucial for establishing the definitive diagnosis in infants with prolonged jaundice. Here, we describe our protocol of using the two-hole laparoscopic technique and discuss its benefits.
  
  
  METHODS
  144 consecutive patients with suspected biliary atresia were included in this retrospective study. A 5-mm umbilical port is introduced for a 30 degrees laparoscope. An additional 5-mm trocar was inserted at right subcostal incision. A liver biopsy was performed first if needed. The fundus of gallbladder was then exteriorized through the incision of the working port after pneumoperitoneum was released and a catheter is inserted into the gallbladder for cholangiography.
  
  
  RESULTS
  The average duration of operation was 34 min (range 20-55 min). Laparoscopic cholangiography failed in 21 cases (14.6%) where atrophic gallbladder was found and BA was confirmed by subsequent laparotomy. For the remaining 123 cases, biliary atresia were diagnosed in 88 (71.5%), biliary hypoplasia in 14 (11.4%), and cholestasis in 21 (17.1%), respectively. There was no bleeding or any other complications intraoperatively.
  
  
  CONCLUSIONS
  The technique of laparoscopic cholecystocholangiography is simple, safe and efficient. It can provide an accurate diagnosis. Furthermore, for patients without biliary atresia, unnecessary laparotomy can be avoided.
authors.affiliation: Department of Pediatric Surgery, BaYi Children's Hospital, Beijing Military Region General Hospital, Beijing, 100700, China.
authors.forename: Liuming
authors.initials: L
authors.lastname: Huang
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Jia
authors.forename: Shuqin
authors.initials: S
authors.lastname: Wang
authors.forename: Baofu
authors.initials: B
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.forename: Shuli
authors.initials: S
authors.lastname: Liu
authors.forename: Wenying
authors.initials: W
authors.lastname: Hou
authors.forename: Long
authors.initials: L
authors.lastname: Li
mesh_terms: D001656:Biliary Atresia / Q000150:complications / Q000175:diagnosis*; D002758:Cholangiography / Q000379:methods*; D002765:Cholecystography / Q000379:methods*; D005260:Female; D005704:Gallbladder / Q000601:surgery; D005748:Gastric Fundus / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007565:Jaundice / Q000209:etiology*; D007567:Jaundice, Neonatal / Q000209:etiology*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
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