Modified laparoscopic external biliary diversion for benign recurrent intrahepatic cholestasis in obese adolescents.

[benign recurrent intrahepatic cholestasis]

Definitive medical treatment for benign recurrent intrahepatic cholestasis (BRIC ) is not available and the significance of surgical treatment is a matter of debate . It has been postulated that BRIC may progress to progressive familial intrahepatic cholestasis (PFIC ), which leads to liver insufficiency and cirrhosis . External biliary diversion represents an option for both conditions and we recently introduced a new laparoscopic technique for infants with PFIC . However , limited umbilical incision may interfere with creating a jejunal conduit by infraumbilical exteriorisation , in particular in obese adolescents . Therefore , we modified our technique by exteriorising a small bowel loop via the right midabdominal trocar incision at the position of the jejunostomy . The technique was used in a 17 -year -old obese patient with BRIC . This is the first report on a patient with BRIC undergoing laparoscopic external biliary diversion .