Lithiase biliaire du nourrisson, de l鈥檈nfant et de l鈥檃dolescent
- 作者：Dominique Debray
- 刊名：La Presse M¨|dicale
- 出版年：2012
- 期刊代码：pca289_07554982
- 类别：med
- 出版时间：May, 2012
- 卷：41
- 期：5
- 页码：466-473
- 文件大小：440 K
摘要
| Figures/TablesFigures/Tables | ReferencesReferencestrong class="boldFont">children trong>, without recognizable predisposing factors in infants or secondary to a predisposing disease such as chronic hemolysis and ileal disease in children. In trong class="boldFont">adolescents trong>, idiopathic cholesterol gallstones accounts for the majority, such as in adults.<p>trong class="boldFont">Gallbladder stones are found in 80 to 90%of cases trong> and common bile duct stones in 10 to 20%of cases.<p>trong class="boldFont">When common bile duct stones are found trong>, a choledocal cyst with anomalous pancreatobiliary duct junction needs to be excluded. Magnetic resonance cholangiopancreatography should be performed in first line.<p>trong class="boldFont">Cholecystectomy trong> is not indicated for silent gallstones, except in children with a predisposing disease such as chronic hemolysis.<p>Treatment of common bile duct stones includes trong class="boldFont">interventional radiologic, endoscopic or surgical procedures trong>. Stone extraction may be performed at endoscopic retrograde cholangiopancreatography with or without sphincterotomy, combined with laparoscopic cholecystectomy. In children without a predisposing disease or no residual gallstones indicating a cholescystectomy, conservative management (percutaneous cholangiography with biliary drainage) may be proposed in specialised centers, especially for infants.<p>A trong class="boldFont">hepaticojejunostomy trong> is indicated in cases of choledocal cyst with anomalous pancreatobiliary duct junctions.