2021 Volume 57 Issue 6 Pages 997-1001
We report a neonatal case of congenital biliary dilatation (CBD) with a very narrow left hepatic duct. A female neonate prenatally diagnosed as having CBD by fetal ultrasonography was born at 37 weeks and 4 days with a birth weight of 3,016 g. Abdominal ultrasonography revealed that the common bile duct was cystically dilated to 50 mm in diameter with irregularly dilated intrahepatic bile ducts, and CBD (Todani Type VI-A) was diagnosed. Her meconium was dark green and her general condition was good, but within a few days, her stool color became white. Because the obstruction of bile drainage was a concern, a radical operation was performed at 10 days after birth. Intraoperative cholangioscopy and cholangiography revealed that the common hepatic duct had cystic dilatation in the hepatic hilum, the right hepatic duct had membranous narrowing, and the left hepatic duct had long segmental stenosis. After total excision of the extrahepatic bile duct, bilateral hepatic ductoplasties were carried out for the biliary reconstruction with wide anastomosis at the hepatic hilum. At that time, hepaticojejunostomy was possible on the right side, but hepatic portojejunostomy (Kasai’s Procedure) was required because the lumen was too narrow on the left side. Her postoperative course was uneventful, she was discharged from the hospital 13 days after surgery, and no complications have been observed over the next 11 years.
