Emergent biliary drainage for choledochal cyst
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概要
- 論文の詳細を見る
Two patients with choledochal cyst who needed an emergent biliary drainage are presented. Case 1: Spontaneous rupture of the cyst was demonstrated by hepatobiliary scintigram in a 21-month-old girl and an emergent T-tube drainage relieved her symptom. Acute obstruction by protein plugs was considered to have caused rapid expansion of the cyst, which resulted in rupture eventually. Case 2: Marked hypoproteinemia was demonstrated in a 29-month-old boy with choledochal cyst. Bile drainage through Foley catheter promptly made the serum protein level elevated above normal range. Portal hypertension due to severely dilated cyst may have increased ascites amount, which caused extracellular fluid shift and protein to be lost into ascites. In both cases the excision of the extrahepatic bile duct and hepaticojejunostomy was carried out successfully later. Treatment of 20 pediatric cases in our institute and the literature were reviewed. Bile drainage would be safer hi emergency condition even though it has been suggested that reconstructive surgery may be tolerable. Definitive surgery should be regarded as a procedure with some risk of postoperative complications because asymptomatic cases operated electively had serious ones. Treatment strategy of patients with choledochal cyst is not straightforward and should be arranged based upon their conditions.
- 東海大学の論文
著者
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Hirakawa Hitoshi
Department of Pediatric Surgery, Tokai University School of Medicine
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Ueno Shigeru
Department of Pediatric Surgery, Tokai University School of Medicine
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Tamano Seiko
Dims Inst. Medical Sci. Inc.
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ICHIHARA Toshio
Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Me
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Kawabe Mayumi
Dims Institute Of Medical Science
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Ogiso Tadashi
Department Of Experimental Pathology And Tumor Biology Nagoya City University Graduate School Of Med
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MAKUUCHI HIROYASU
Department of Cardiovascular Surgery, Tokai University Hospital
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Hirose Masao
Division Of Pathology National Institute Of Health Sciences
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Asamoto Makoto
Department Of Experimental Pathology And Tumor Biology Nagoya City University Graduate School Of Med
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YOKOYAMA Seishichi
Department of General Surgery, School of Medicine, Tokai University
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IMAIZUMI TOSHIHIDE
Department of Gastroenterological Surgery, Tokyo Women's Medical University
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Ichihara Toshio
Dims Institute Of Medical Science
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Imaida Katsumi
Kagawa University Faculty Of Medicine Department Of Pathology And Host-defense Onco-pathology
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Makuuchi Hiroyasu
Department Of Cardiovascular Surgery Tokai University Hospital
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Imaizumi Toshihide
Department Of Gastroenterological Surgery Tokyo Women's Medical University
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Shirai Tomoyuki
Department Of Biochemistry Niigata College Of Pharmacy
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Ueno Shigeru
Department Of Pediatric Surgery Gastrointestinal Surgery And Radiology Tokai University School Of Me
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Yokoyama Seishichi
Department Of General Surgery School Of Medicine Tokai University
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Hirakawa Hitoshi
Department Of Orthopaedic Surgery Hirosaki University School Of Medicine
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Miyashita Kayoko
Dims Institute Of Medical Science
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Imaizumi Toshihide
Department Of Gastroenterological Surgery Tokyo Women's Medical College
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UENO Shigeru
Department of Pediatric Surgery and Gastrointestinal Surgery, Tokai University School of Medicine
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Miyashita Kayoko
Department of Pediatric Surgery and Gastrointestinal Surgery, Tokai University School of Medicine
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Kawabe Mayumi
Department of Pediatric Surgery and Gastrointestinal Surgery, Tokai University School of Medicine
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IMAIZUMI Toshihide
Department of Pediatric Surgery and Gastrointestinal Surgery, Tokai University School of Medicine
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HIRAKAWA Hitoshi
Department of Pediatric Surgery and Gastrointestinal Surgery, Tokai University School of Medicine
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YOKOYAMA Seishichi
Department of Pediatric Surgery and Gastrointestinal Surgery, Tokai University School of Medicine
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MAKUUCHI Hiroyasu
Department of Pediatric Surgery and Gastrointestinal Surgery, Tokai University School of Medicine
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ICHIHARA Toshio
Department of Earth and Space Science, Faculty of Science, Osaka University
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