Pediatric biliary interventions.

摘要: The most common indication for percutaneous biliary evaluation and intervention in children is the diagnosis treatment of liver transplant complications, including strictures bile leaks. Because transplants are commonly performed using a Roux-en-Y biliary-enteric anastomosis, endoscopic retrograde cholangiopancreatography not technically possible; therefore, first-line procedure obstruction this population transhepatic cholangiography (PTC). Percutaneous can be challenging these patients, because ductal dilation may minimal or altogether absent pediatric livers even setting severe obstruction. However, with proper technique, use ultrasound guidance, technical success rates PTC drainage similar to those adults. Biliary stenosis management long-term commitment that usually takes several months more than year require multiple repeat cholangioplasties catheter exchanges. Due its minimally invasive nature relatively low morbidity mortality compared open surgical alternatives, should considered option who have had previous transplant, nontransplant patients cannot treated endoscopically.