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Year : 2020  |  Volume : 53  |  Issue : 3  |  Page : 109-112

Bile duct lavage and cholecystectomy: A single-stage operation for inspissated bile syndrome

1 Department of Paediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India
2 Department of Radiodiagnosis, SMS Medical College, Jaipur, Rajasthan, India
3 Department of Paediatrics, SMS Medical College, Jaipur, Rajasthan, India

Correspondence Address:
Dr. Rahul Gupta
Department of Paediatric Surgery, SMS Medical College, Jaipur, Rajasthan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/fjs.fjs_110_19

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A 90-day-old infant with inspissated bile syndrome unresponsive to medical management is presented. The infant was born premature, low birth weight (1600 g) at 28 weeks, became jaundice few days after birth. He received neonatal intensive care therapy for 4 weeks. Investigations on admission revealed conjugated hyperbilirubinemia (total bilirubin – 8.26 mg/dl). Abdominal ultrasound and magnetic resonance cholangiopancreatography were suggestive of biliary atresia with nonvisualization of the gallbladder and common bile duct (CBD). Intraoperatively, cholecystotomy confirmed the presence of bile; placement of infant feeding tube in the infundibulum with saline irrigation confirmed CBD obstruction. After multiple gentle attempts with saline lavage, distal clearance was achieved, suggested by duodenal filling up with saline and by nasogastric aspiration. The patient passed colored (bile containing) stools with bile plugs on the 5th postoperative day. Bilirubin values returned to normal, and the outcome was favorable.

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