Operation of the bile duct

Operation of the bile duct's disease overview

Molecular duct cyst is a congenital malformation of bile ducts, which is defined when the bile duct is 1cm or more. congenital bile duct cysts occupy mainly in the group of biliary cysts inside and outside the liver, so it is named for this complex disease group. This is a rare situation in Western countries but popular in Asian countries, including Vietnam. The common rate is about 1/100,000 - 1/150,000 children. In Japan, the bile duct cysts may be encountered at 1/1000 people. Women suffer from congenital biliary cysts more than men, 3 to 4 times higher. Children's bile duct cysts are usually diagnosed before 10 years old, mainly in the newborn period.

Is the bile duct cysts dangerous?

Children's bile duct cysts often have nonspecific symptoms so parents are often easily ignored. The disease if not treated often has many dangerous complications such as biliary tract infections, bile, gallstones, pancreatitis for a long time can lead to cirrhosis, bile cancer. The risk of progress depends on each disease and the age of the patient. Cirrhosis, increased portal venous system is a long -term complication in adults with a rate of about 30%. Biliary cancer is the most dangerous complication, common with the rate of about 9 - 28%.

The bile duct cyst is divided into 5 types, depending on the shape and position of the follicles. Specifically as follows:

Type 1: Mostly with 80-90 % of cases. Normal follicles or rhombus, appearing in the bile duct.

type 2: The follicles have the form of excess bags, protruding from the wall of the bile duct and connecting to the bile duct through a small tube. type 3: The follicles come from the low part of the bile duct, below the d2 of the duodenum.

Mixed follicles (type 4) type 4: Also known as a mixed cyst because there are many different shapes. This is a great dilatation of the bile sugar system inside and outside the liver. type 5: Also known as checkeri disease, the follicles only appear in the biliary system in the liver.

The main method of treatment is the surgery to remove the bile duct that contains cysts and bile bile. The current method of surgery only acts as a solution, but can minimize the rate of complications of the disease. There is no specific treatment for the disease.

Causes of Operation of the bile duct's disease

Bile duct cysts are congenital pathogens, the forms of bile ducts formed from the time of the fetus in the womb. The cause of the disease has not been studied much. The hypothesis is most supported by the existence of the pancreatic bile duct, causing the pancreatic fluid to overtake the bile duct system, causing long -term bile ducts.

Symptoms of Operation of the bile duct's disease

Children's bile duct cysts often manifest clinically with symptoms such as:

jaundice, yellow eye: Usually found in infants and young children. Jaundice in infants often appear early, the level of jaundice depends on the severity of the disease.

Abdominal pain: common in older children, less common in infants and young children. Abdominal pain can recur many times. Abdominal pain and jaundice are two classic symptoms of the bile duct cysts.

Fever if there is complication of biliary tract infections, peritonitis.

Touch the tumor in the abdomen

Transmission route of Operation of the bile duct's diseaseOperation of the bile duct

congenital bile duct cysts are not transmitted from patients to healthy people.

People at risk for Operation of the bile duct's disease

There is no risk factor that is determined to increase the incidence of bile duct cysts. Family history with relatives with congenital bile duct cysts can be a vigilant factor for patients.

Prevention of Operation of the bile duct's disease

This is a birth defect. The best prevention is to detect and treat early when the disease has no complications.

Today, along with the advancement of science and technology, examination and prenatal screening can detect bile duct cysts right from the moment of pregnancy.

Diagnostic measures for Operation of the bile duct's disease

Clinical symptoms such as jaundice, abdominal pain are only suggested. The diagnosis of the disease is based on the diagnostic media as follows:

Abdominal ultrasound: Evaluating the form of the biliary tract inside and outside the liver, damage to the liver parenchyma if any.

Magnetic resonance imaging: is a modern diagnostic means, advantages than abdominal ultrasound, accurate assessment of biliary images.

Blood tests: Evaluation of liver function

Operation of the bile duct's disease treatments

Molh bile cyst surgery is the current main treatment. The principle of surgery is to remove all the large bile ducts and the gallbladder, then re -restrain the intestinal bile circulating by sewing the remaining liver pipe to the small intestine and duodenum. Thus, after surgery, bile fluid still circulated to the intestine to continue the role of digesting food.

Owner of the bile duct cysts is usually performed when the child is over 3 months old if the disease has been diagnosed before birth and has no symptoms. If there are manifestations of jaundice, yellow eyes, children should be intervened early 1-2 months. In the event that children are hospitalized with complications such as cholangitis, peritonitis, it is necessary to stabilize the total condition by medical treatment before conducting surgery to solve the cause.

There are two main surgical methods: open surgery and laparoscopic surgery.Open surgery

This is a classical intervention. However, this method has quite a lot of complications such as muscle damage, long surgical scars, bad, pain, slow recovery, so it is no longer selected as much as before.

Bile cyst endoscopic surgery:

This is a new method that is effective in the treatment of bile duct cysts. Endoscopic surgery remedies the limitations of open surgery such as: less pain, fast recovery, less abdominal wall damage, fast wound healing and leaving no bad scars.

One -hole endoscopic surgery is the least invasive surgical method. The doctor only paved a small line, usually shorter than 2cm to put the surgical device in. This technique is much less invasive than conventional laparoscopic surgery that needs 4 separate lines. However, this method is difficult to do because surgical tools must be crowded in a line, so the doctors are skilled, fluent in the use of laparoscopic surgery tools to promote all the advantages of One -hole endoscopic surgery.

After surgery, children are often hospitalized for 5-7 days. During the hospital, dullness must be fasted, nourished by intravenous tract for the first few days. A catheter from the abdomen is placed to escape. Children are also placed in the stomach catheter to translate and ask from the stomach to escape.

Lilly technique: Remove the entire cyst mucosa and only leave fibrous fibroids when it is not possible to surgery to remove the cystic tumor as cystic cysts stick to the portal vein system. This method helps reduce the rate of complications of biliary cancer.

Some complications may occur after surgery:

Bleeding

Infections of biliary tract infection

Complications at the mouth of the mouth such as narrow, podium, leakage through the mouth.

Children need to be re -examined and monitored after 1 month, 6 months, 1 year or as soon as abnormal symptoms such as vomiting, abdominal pain, jaundice, fever, fever .

In cases where biliary tract follicles occur in both lobes, patients have complications such as bile cirrhosis, liver failure or increased portable vein pressure may have liver transplantation.

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