Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Year : 2017 | Month : July | Volume : 11 | Issue : 7 | Page : PR01 - PR04

External Drainage of Giant Infantile Choledochal Cyst before Definitive Repair: Is it Worth?

Vijai Datta Upadhyaya, Basant Kumar, Sandeep Kumar Raut, Eti Sthapak

1. Assistant Professor, Department of Paediatric Surgery, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India. 2. Assistant Professor, Department of Paediatric Surgery, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India. 3. Postdoctoral Fellowship, Department of Paediatric Surgery, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India. 4. Assistant Professor, Department of Anatomy, Eras Medical College, Lucknow, Uttar Pradesh, India

Correspondence Address :
Dr. Vijai Datta Upadhyaya,
Assistant Professor, Department of Paediatric Surgery, Sanjay Gandhi Postgraduate Institute of Medical Science,
Lucknow, Uttar Pradesh, India.
E-mail: upadhyayavj@rediffmail.com

Abstract

Infantile Choledochal Cysts (IFCC) usually present with jaundice, acholic stool and abdominal lump or abdominal distension. If the surgical intervention is delayed, they rapidly progress to liver fibrosis which is considered to be irreversible if progressed to cirrhosis. We present the data of four cases (aged one month to seven months) of IFCC presented with cholangitis managed in one surgical unit in last two years. In one case, cholangitis was treated with prolonged antibiotic course before definitive repair whereas in rest, external drainage of cyst was done in addition to intravenous antibiotic to treat cholangitis. All the infants had features of cholangitis at time of presentation. Total leucocyte count ranged from 18x1000/UL to 30.6x1000/UL. Total bilirubin level at presentation ranged from 8.2 mg/dl to 18 mg/dl and Prothrombin time (INR) ranged from 1.33 to 1.9. Hepatic fibrosis was observed in all cases but cirrhosis was observed in only one case. There was no mortality but one patient had postoperative complication with prolonged hospital stay. External drainage helps in early recovery from cholangitis and better optimization of liver function. It also delays further progression to liver fibrosis by relieving the biliary outflow obstruction while waiting for definitive repair.

Keywords

Antibacterial agents, Bilirubin, Liver cirrhosis

How to cite this article :

Vijai Datta Upadhyaya, Basant Kumar, Sandeep Kumar Raut, Eti Sthapak. EXTERNAL DRAINAGE OF GIANT INFANTILE CHOLEDOCHAL CYST BEFORE DEFINITIVE REPAIR: IS IT WORTH?. Journal of Clinical and Diagnostic Research [serial online] 2017 July [cited: 2017 Oct 18 ]; 11:PR01-PR04. Available from
http://jcdr.net/back_issues.asp?issn=0973-709x&year=2017&month=July&volume=11&issue=7&page=PR01-PR04&id=10125

DOI and Others

DOI: 10.7860/JCDR/2017/22210.10125


Date of Submission: Jun 22, 2016
Date of Peer Review: Aug 27, 2016
Date of Acceptance: Feb 11, 2017
Date of Publishing: Jul 01, 2017


Financial OR OTHER COMPETING INTERESTS: None.

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