title: Endoscopic management of biliary complications after partial liver resection in children.
abstract: BACKGROUND
  Biliary complications after liver surgery are difficult to manage. Endoscopic retrograde cholangiopancreatography (ERCP) with stenting of the common bile duct is not commonly practiced in children for this purpose. The aim of this retrospective review is to evaluate the role of ERCP as both a diagnostic and a therapeutic tool in the management of biliary complications after liver resection in children.
  
  
  METHODS
  The charts of all patients from 0 to 18 years old who underwent partial liver resection in a tertiary children's hospital in Amsterdam, the Netherlands, between 2000 and 2010 were retrospectively reviewed.
  
  
  RESULTS
  Forty-five children (median age: 3.6 years, range: 2 months-17 years) underwent partial liver resection. Post-operative biliary complications occurred in 13 children. Ten patients were suffering from bile leakage. Eight of them underwent ERCP with stent placement after which leakage stopped in 5 patients. Three patients presented with a post-operative biliary tract stricture. ERCP with dilation and stent placement was performed in 2 of them, which solved the problem in one patient. ERCP demonstrated the nature (bile leak and/or biliary tract stricture(s)), extent, and location of the lesion in 8 of 10 children. There were no serious procedure related complications. Rescue procedures in the other patients included hepaticojejunostomy and liver transplant.
  
  
  CONCLUSIONS
  ERCP with stenting of the common bile duct has a diagnostic and therapeutic role in the management of bile leaks after partial liver resection in children. The value of ERCP in the management of a stricture of the biliary tract is less conclusive.
authors: Paediatric Surgical Centre of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
authors: Mette W
authors: MW
authors: Steen
authors: Roel
authors: R
authors: Bakx
authors: Merit M
authors: MM
authors: Tabbers
authors: Jim C H
authors: JC
authors: Wilde
authors: Krijn P
authors: KP
authors: van Lienden
authors: Marc A
authors: MA
authors: Benninga
authors: Hugo A
authors: HA
authors: Heij
authors: Erik A J
authors: EA
authors: Rauws
mesh_terms: D000293:Adolescent; D001660:Biliary Tract Diseases / Q000209:etiology* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D016145:Endoscopy, Digestive System; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies