title: Inspissated bile syndrome; Safe and effective minimally invasive treatment with percutaneous cholecystostomy in neonates and infants.
abstract: OBJECTIVE
  Inspissated bile syndrome (IBS) is a rare cause of obstructive jaundice in neonates and infants with several treatment options reported. We present our experience with the use of minimally invasive ultrasound-guided percutaneous cholecystostomy drain catheter placement with ongoing saline lavage in neonates and infants.
  
  
  METHODS
  Retrospective chart review of patients treated with percutaneous cholecystostomy, from February 2010 till June 2015. We reviewed the technical and clinical success along with complications of the procedure.
  
  
  RESULTS
  There were 6 patients, mean age 17weeks (range 4-40). Most had significant risk factors for IBS presenting with biliary obstruction. A total of 7 procedures performed on the 6 patients, with a technical success rate of 6/7. One patient required cannulation of the intrahepatic biliary system. Drains were flushed for a median of 26days (10-70). Clinical success was achieved in all patients. 3 had displacement of the drain, one of which required re-insertion. Another developed a small sub-hepatic collection post procedure with pyrexia. On long term follow up one was found to have a forme fruste choledochal cyst.
  
  
  CONCLUSIONS
  Centers with suitable interventional radiology services ultrasound-guided percutaneous cholecystostomy drain catheter placement with ongoing saline lavage is a safe and effective minimally invasive treatment for IBS in neonates and infants.
authors.affiliation: Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, Australia. Electronic address: bapeshbollu@gmail.com.
authors.forename: Bapesh K
authors.initials: BK
authors.lastname: Bollu
authors.affiliation: Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dawrant
authors.affiliation: Department of Gastroenterology, The Children's Hospital at Westmead, Sydney, Australia.
authors.forename: Kunal
authors.initials: K
authors.lastname: Thacker
authors.affiliation: Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, Australia.
authors.forename: Gordon
authors.initials: G
authors.lastname: Thomas
authors.affiliation: Department of Radiology, The Children's at Hospital Westmead, Sydney, Australia.
authors.forename: Murthy
authors.initials: M
authors.lastname: Chenapragadda
authors.affiliation: Department of Gastroenterology, The Children's Hospital at Westmead, Sydney, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Gaskin
authors.affiliation: Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, Australia.
authors.forename: Albert
authors.initials: A
authors.lastname: Shun
mesh_terms: D002767:Cholecystostomy / Q000379:methods*; D015529:Choledochal Cyst / Q000601:surgery*; D002779:Cholestasis / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013577:Syndrome; D016896:Treatment Outcome
keywords: Inspissated bile syndrome; Percutaneous cholecystostomy