Abdominal Wall Traction for Laparoscopic Cholangiography in Patients with Infantile Jaundice

Abstract

ABSTRACT

Laparoscopy is performed to differentiate between biliary atresia and neonatal hepatitis in patients with infantile jaundice. However, any change in intra-abdominal pressure can cause a loss of the visual field. The authors use abdominal wall traction in these patients. Seven patients (age range: 29 days to 3 months) with persistent jaundice underwent laparoscopy and laparoscopic cholangiography with abdominal wall traction using a Kirschner wire. The body of the gallbladder could not be visualized until the liver was elevated. Using the abdominal wall traction method, the gallbladder was easily seen without retracting it anteriorly and superiorly. Six of the seven patients had biliary atresia. These patients underwent Kasai's procedure immediately after cholangiography or inability to cannulate the gallbladder. One patient had neonatal hepatitis. The incision in the gallbladder was closed using laparoscopic suture techniques, and a liver biopsy was performed with laparoscopic cautery scissors. There were no complications. This method improves visibility and increases the safety and ease of laparoscopic cholangiography in patients with infantile jaundice.