PEI Wei,GAO Ming-tai,LIU Deng-rui,et al.Domestic pediatric spontaneous biliary perforation in 320 cases of clinical meta-analysis[J].Journal of Clinical Pediatric Surgery,,12():113-116.[doi:10.3969/j.issn.1671— 6353.2013.02.011]
Domestic pediatric spontaneous biliary perforation in 320 cases of clinical meta-analysis
Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R]
volume:
第12卷
Number:
2013 02
Page:
113-116
Column:
论著
Date of publication:
2013-04-28
- Keywords:
- Biliary Tract Diseases/DI; Biliary Tract Diseases/TH; Child
- Abstract:
- Objetive To analyze the reports of spontaneous perforation of the bile duct in infancy and childhood(SPBD)in the last 22 years and to explore the domestic the SPBD clinical presentation and management. Methods Searches were carried out using CNKI, Wanfang Data and VIP Chinese Periodical Database, extract the standards-compliant of clinical data to summarize and analyze. Results In total, 320 cases of SPBD were identified, male:female=1:1.74, the average age was 3.82 years. The most common presenting symptom was abdominal distension(86.8%), vomiting(76.8%), abdominal pain(75.8%), fever(68.8%), jaundice(38.6%), pale-coloured stools(23.5%), shifting dullness(31.5%),right upper quadrant mass(16.0%), with the progression of course of SPBD, peritoneal irritation(46.6%), bowel sounds diminished or disappeared(27.6%)will appear. These confirmed only 75 cases without surgery, the rate of preoperative diagnosis was 23.4%, of which 71 cases(94.7%)of the confirmed cases diagnosed by abdominal paracentesis, 245 cases(76.6%)confirmed by surgery. All cases had surgical treatment. There were several methods of management in first surgery, including both T-tube drainage and abdominal drainage(63.2%), peritoneal drainage alone(14.7%), gallbladder fistula drainage(7.2%), Roux-en-Y hepaticojejunostomy atⅠstage(2.0%), 50.2% of these subsequently required biliary reconstruction atⅡstage. The mortality rate was 6.9%. Conclusions The disease of children has a rapid progress, early diagnosis can be by clinical manifestations abdominal paracentesis and abdominal ultrasound scan or computed tomography(CT),active surgical treatment is the key to treat SPBD and reduce mortality.
References:
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Last Update:
2013-04-30