Medih ÇELİKTAŞ

Percutaneous Transhepatic Biliary Interventions in Benign Diseases of Children

Amaç: Perkütan transhepatik biliyer girişimler erişkinlerde güvenli ve etkili bir biçimde uygulanmaktadır. Çocukluk çağı benign hastalıklarında kullanımı konusundaki deneyimler daha azdır. Çalışmamızda çocukluk çağı benign hastalıklarında yöntemin güvenilirliği ve etkinliği araştırılmıştır. Materyal ve Metod: Bu retrospektif çalışmada, ortalama yaşı 10.2 (ranj 14 gün-14 yaş) olan 15 çocuğa perkütan biliyer girişim uygulanmıştır. Beş hasta sarılık,10 hasta kolanjit yakınmaları ile başvurmuştur. Perkütan transhepatik biliyer drenaj (PTBD) 10 hastaya, PTBD ve balon dilatasyon 3 hastaya, perkütan kolesistomi (PK) 1 hastaya, PTBD yi takiben PK bir hastaya uygulanmıştır. Bulgular: Uygulanan bütün işlemler teknik olarak başarıyla sonuçlandırılmıştır. İşleme bağlı mortalite olmamıştır. Oniki hastada serum bilüribin seviyeleri normal veya normale yakın seviyelere dönmüştür. İşlemden önce mevcut kolanjit ve akut kolesistit iyileşmiştir. Altı hastaya perkütan işlem sonrası cerrahi uygulanması gerekmiştir. Dokuz hasta ileri tedaviye ihtiyaç duyulmaksızın primer olarak perkütan girişimle iyileşmiştir. Sonuç: Perkütan biliyer girişimler çocukluk çağı benign hastalıklarında etkili bir biçimde uygulanabilir. Primer tedavi yöntemi olarak veya cerrahi öncesi kullanılabilir. Birçok olguda perkütan tedavi yeterli olmuş ve gereksiz cerrahi önlenmiştir

Çocukluk Çağı Benign Hastalıklarında Perkütan Transhepatik Biliyer Girişimler

Purpose: Percutaneous transhepatic biliary interventions are performed safely and effectively in adults. There is less experience of these interventions in benign diseases of children. We aimed to evaluate the safety and efficacy of percutaneous biliary interventions in benign diseases of children. Materials and Methods: In this retrospective study, percutaneous biliary interventions were performed in fifteen children with a mean age of 10.2 years (range 14 days-14 years). Patients presented with jaundice (n=5) and/or cholangitis (n=10). Percutaneous transhepatic biliary drainage (PTBD) performed in 10 patients, PTBD plus balloon dilation in 3, percutaneous cholecystostomy (PC) in 1, PTBD following PC in 1. Results: All procedures were technically successful. No procedure-related mortality occurred in patients. Serum bilirubin levels returned to normal or near normal in ten of twelve cases. Preexisting cholangitis and acute cholecystitis resolved in all patients. Six patients underwent surgery following percutaneous management. Nine patients cured primarily with percutaneous interventions with no further treatment. Conclusion: Percutaneous biliary interventions can be performed effectively in benign diseases of children. It can be performed either as a primary treatment modality or as a bridge prior to surgery. In most of cases, percutaneous treatment is sufficient and unnecessary surgery is prevented

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