title: Hitching the gallbladder in laparoscopic-assisted cholecysto-cholangiography: a simple technique.
abstract: Neonatal cholestatic disorder in the late neonatal period requires often cholangiography to differentiate between biliary atresia and other causes of prolonged neonatal jaundice. A simplified method of a laparoscopic-assisted cholecysto-cholangiography is presented. Retrospective chart review was conducted of all patients who from May 2002 to April 2012 underwent a laparoscopic-assisted cholecysto-cholangiography with routine fixation of the fundus of the gallbladder to the lateral aspect of the abdominal wall. A total of 18 infants (8 boys) aged 41-104 (median 64) days underwent laparoscopic-assisted cholecysto-cholangiography for prolonged jaundice. The technique identified ten cases of a patent bile duct system and eight biliary atresias. (Thirty-two cases of suspected biliary atresia were confirmed by laparoscopy alone.) Two cases required suturing of a bile leak at the puncture site. Hitching the gallbladder to the lateral abdominal wall is a simple method allowing an optimal radiographic assessment of the extra- and intra-hepatic bile duct anatomy.
authors.affiliation: Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. chhouben@web.de
authors.forename: C H
authors.initials: CH
authors.lastname: Houben
authors.forename: H Y
authors.initials: HY
authors.lastname: Wong
authors.forename: W C
authors.initials: WC
authors.lastname: Mou
authors.forename: K W
authors.initials: KW
authors.lastname: Chan
authors.forename: Y H
authors.initials: YH
authors.lastname: Tam
authors.forename: K H
authors.initials: KH
authors.lastname: Lee
mesh_terms: D001652:Bile Ducts / Q000002:abnormalities; D001656:Biliary Atresia / Q000150:complications / Q000000981:diagnostic imaging; D002758:Cholangiography / Q000379:methods*; D003287:Contrast Media; D005260:Female; D005704:Gallbladder / Q000601:surgery*; D006801:Humans; D007223:Infant; D007567:Jaundice, Neonatal / Q000209:etiology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol