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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
.
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"been postulated that"
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benign recurrent intrahepatic cholestasis
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