Surgical management of biliary tree diseases in children at Tikur Anbessa Specialized Hospital :a10 year retrospective study
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Date
2021-06
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Addis Abeba University
Abstract
Abstract
Background Information-biliary tree diseases are diseases affecting bile ducts, gallbladder and
other structures involved in production and transportation of bile. A diverse spectrum of diseases
affects the biliary system, often presenting with similar clinical signs and symptoms. These
conditions include gallstones, cholecystitis, cholangitis, biliary tract cysts, congenital biliary
atresia and others.
Biliary atresia is a progressive obstructive cholangiopathy of unknown etiology, occurring during
the perinatal period. If left untreated it progresses to liver fibrosis and cirrhosis in the first few
months of life. Timely Kasai porto-enterostomy restores bile flow enhancing survival and thus
age at diagnosis is a potentially modifiable risk factor.
choledocal cyst is a rare congenital anomaly of the bile duct which is defined as pathological
dilatation of the bile duct. If left untreated it has complications which range from biliary duct
obstruction to cholangiocarcinoma. Total cyst excision and biliary reconstruction is the treatment
of choice.
Little is known about the epidemiology of cholelithiasis in children. Cholelithiasis and
choledocholithiasis have been increasingly diagnosed in recent years in children. This
phenomenon may be attributed to better medical imaging (especially ultrasonography) and its
usage in investigating children with unexplained abdominal pain and/or a genuine increase in the
incidence.
Objective- to assess clinical presentation, clinical course and outcome of pediatric patients
operated at TASH with biliary tree diseases.
Methodology: a retrospective study using structured questionnaire was used to collect data on
pediatric patients operated at TASH for the diagnosis of biliary tree diseases from Jan 2010 to
Jan 2020.The collected data was checked for completeness and analyzed using software SPSS
23.
Results and discussion-60% of patients operated for biliary tree and 87% of choledocal cysts
were females. More than 60% of biliary atresia patients were operated within the 1
3
months.75% of choledocal cyst was type I and the rest type II.1/3 of patients operated for BA
had their jaundice cleared on follow up.
Conclusion-age at KPE and post kasai jaundice clearance is low in our setting but similar with
other African countries. Type II choledocal cyst is the 2
nd
commonest type in our setting unlike
other studies.
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Keywords
Biliary tree diseases,children,Surgical management