Early outcomes of laparoscopic surgery for biliary atresia.
OBJECTIVE
The aim of the study was to present early outcomes of the laparoscopic technique for biliary atresia with some technical modifications.


METHODS
We reviewed charts of all patients with biliary atresia who underwent laparoscopic portoenterostomy from July to December 2008. There were 11 patients with biliary atresia, including 5 boys and 6 girls. The operation was carried out using 4 trocars. The liver was elevated by 2 transcutaneous stay sutures: one on the round ligament and the other on the gallbladder remnant. The left and right hepatic arteries and portal veins were dissected and retracted laterally by 2 transcutaneous sutures to expose the liver hilum. A stay suture was placed on fibrotic tissue at the liver hilum to facilitate its maximal removal. A jejunal end-to-side anastomosis was constructed extracorporeally. Portoenterostomy was carried out laparoscopically.


RESULTS
Mean operative time was 245 +/- 31 minutes. No patient required conversion. There were no operative deaths. Blood loss during operation was minimal. One patient died on day 65 after operation because of intractable hepatic liver. Follow-up after discharge from 10 to 16 months revealed that 6 patients still survived and 4 patients died. One patient died because of milk aspiration at 12 months of age. Three patients died because of repeated cholangitis and liver failure at 10, 10, and 14 months, respectively.


CONCLUSIONS
With a modified laparoscopic technique, good early outcomes of laparoscopic surgery for biliary atresia were achieved.
Liem
Nguyen Thanh
NT
National Hospital of Pediatrics, Hanoi, Vietnam. liemnhp@hotmail.com
Son
Tran N
TN
Quynh
Tran A
TA
Hoa
Nguyen P Anh
NP
D001656:Biliary Atresia / Q000401:mortality / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002423:Cause of Death; D002779:Cholestasis / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D011171:Portoenterostomy, Hepatic / Q000379:methods* / Q000706:statistics & numerical data; D015996:Survival Rate; D013536:Suture Techniques; D016896:Treatment Outcome