Indications and Results of Biliary Lavage in Infants With Cholestasis

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Purpose: We reviewed cases of cholestasis in infants to investigate the indications and effects of biliary lavage. Methods: We retrospectively reviewed the clinical features and treatments performed in 9 patients who presented with pale stools and direct hyperbilirubinemia in early childhood. The patients were treated between May 2005 and April 2009. Results: Intraoperative cholangiography was performed in 5 patients (cholangiography group). In 4 of these patients, an obstruction of the common bile duct was resolved with repeated biliary saline lavage (biliary-lavage group): 2 cases improved rapidly while the remaining 2 cases were improved using steroid pulse therapy. Medication was effective in treating the other 5 cases (non biliary lavage group). In the biliary-lavage group (n = 4), long-term fasting was enforced and total parenteral nutrition was administered, and by performing imaging tests of the biliary tract, we observed abnormal findings such as biliary dilatation, debris, and stones. However, these findings were not observed in the non biliary lavage group (n = 5). Conclusions: In patients exhibiting abnormal findings of the biliary tract caused by long-term fasting and total parenteral nutrition, biliary lavage should be recommended.
特定非営利活動法人日本小児外科学会の論文