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Clinical features and risk factors of bile duct perforation associated with pediatric congenital biliary dilatation

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Abstract

Purpose

This study aimed to investigate the clinical features and risk factors of bile duct perforation in pediatric congenital biliary dilatation (CBD) patients.

Methods

CBD patients, whose initial symptom was abdominal pain, were enrolled in this study and were divided into perforated and non-perforated groups. The clinical features of the perforated group were investigated. Moreover, the age at operation, sex, and morphologic features of the extrahepatic bile duct were compared between the groups.

Results

Fifteen cases of bile duct perforation (10.4%) were identified among the 144 CBD patients who had abdominal pain. Majority of bile duct perforation occurred in patients aged < 4 years. The median duration from onset of abdominal pain to bile duct perforation was 6 (4–14) days. Age at onset [< 4 years old; P = 0.02, OR 13.9, (1.663, 115.3)], shape of extrahepatic bile duct [non-cystic type; P = 0.009, OR 8.36, (1.683, 41.5)], and dilatation of the common channel [P = 0.02, OR 13.6, (1.651, 111.5)] were risk factors of bile duct perforation.

Conclusions

Emergent bile duct drainage might be planned to prevent bile duct perforation if CBD patients have the abovementioned risk factors and experience persistent abdominal pain lasting for a few days from onset.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Division of Pediatric Surgery, Department of Surgery, Kobe University School of Medicine, Kobe, Japan

    Hiroaki Fukuzawa, Insu Kawahara, Keiichi Morita & Kosaku Maeda

  2. Department of Pediatric Surgery, Kobe Children’s Hospital, Chuou-ku minatojimaminami 1-6-7, Kobe, 650-0047, Japan

    Hiroaki Fukuzawa, Keisuke Kajihara, Insu Kawahara, Kaori Isono, Yoshitomo Samejima, Shizu Miura, Kotaro Uemura, Keiichi Morita, Makoto Nakao, Akiko Yokoi & Kosaku Maeda

  3. Department of Pediatric Surgery, Shizuoka Children’s Hospital, Shizuoka, Japan

    Naoto Urushihara, Koji Fukumoto & Masaya Yamoto

  4. Department of Pediatrics, Kobe City Medical Center General Hospital, Kobe, Japan

    Chisato Miyakoshi

Authors
  1. Hiroaki Fukuzawa
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  2. Naoto Urushihara
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  3. Chisato Miyakoshi
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  4. Keisuke Kajihara
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  5. Insu Kawahara
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  6. Kaori Isono
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  7. Yoshitomo Samejima
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  8. Shizu Miura
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  9. Kotaro Uemura
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  10. Keiichi Morita
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  11. Makoto Nakao
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  12. Akiko Yokoi
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  13. Koji Fukumoto
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  14. Masaya Yamoto
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  15. Kosaku Maeda
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Corresponding author

Correspondence to Hiroaki Fukuzawa.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution or practice at which the studies were conducted.

Informed consent

For this study, informed consent was not required.

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Fukuzawa, H., Urushihara, N., Miyakoshi, C. et al. Clinical features and risk factors of bile duct perforation associated with pediatric congenital biliary dilatation. Pediatr Surg Int 34, 1079–1086 (2018). https://doi.org/10.1007/s00383-018-4321-6

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  • DOI: https://doi.org/10.1007/s00383-018-4321-6

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