Stenting of the biliary tract in children

Percutaneous transhepatic biliary drainage in an infant with obstructive jaundice caused by neuroblastoma

Neuroblastoma presenting with obstructive jaundice is a rare event. Management of this condition includes surgery, chemotherapy, radiotherapy, temporary cholecystostomy tube, endoscopic retrograde cholangiopancreatography (ERCP), and internal biliary drainage (IBD). We herein describe our experience with one infant affected by neuroblastoma presenting with jaundice, who successfully underwent percutaneous transhepatic biliary drainage (PTBD). This report introduces PTBD as a viable treatment option for neuroblastoma and obstructive jaundice and provides a review of the pertinent literature.

Percutaneous management of tumoral biliary obstruction in children

BACKGROUND

There is limited experience of percutaneous biliary interventions in children although they are safe and effective procedures.

OBJECTIVE

To evaluate the efficacy and safety of percutaneous management of tumoral biliary obstruction in children.

MATERIALS AND METHODS

Percutaneous biliary interventions were performed in eight children (six boys, two girls) with a mean age of 10.5 years (range 4-17 years). The interventions included percutaneous biliary drainage (five patients), percutaneous biliary drainage and placement of a self-expanding metallic stent (two patients), and percutaneous cholecystostomy (one patient). All patients had signs of obstructive jaundice and two had cholangitis.

RESULTS

All procedures were successful. No procedure-related mortality was observed. Bilirubin levels returned to normal in four of the eight patients. Findings of cholangitis resolved in the two affected patients after the procedure and antibiotic treatment. Two patients underwent surgery after percutaneous biliary drainage procedures. A self-expanding metallic stent was placed in two patients with malignancy and the stents remained patent until death.

CONCLUSION

Percutaneous biliary interventions can be performed safely for the management of tumoral biliary obstruction in children.