Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2023; 11(11): 2502-2509
Published online Apr 16, 2023. doi: 10.12998/wjcc.v11.i11.2502
Application of endoscopic retrograde cholangiopancreatography for treatment of obstructive jaundice after hepatoblastoma surgery: A case report
Jun Shu, Hu Yang, Jun Yang, Hong-Qiang Bian, Xin Wang
Jun Shu, Hu Yang, Jun Yang, Hong-Qiang Bian, Xin Wang, Department of General Surgery, Wuhan Children’ Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
Author contributions: Wang X and Shu J designed the research study; Wang X and Yang H performed the research; Wang X, Yang J, and Bian HQ analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript.
Informed consent statement: The study received the patient’s consent and approval from the hospital's ethics committee.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin Wang, MD, Surgeon, Department of General Surgery, Wuhan Children’ Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hong Kong Road, Wuhan 430000, Hubei Province, China. wangxin20150710@163.com
Received: December 2, 2022
Peer-review started: December 2, 2022
First decision: January 5, 2023
Revised: January 14, 2023
Accepted: March 21, 2023
Article in press: March 21, 2023
Published online: April 16, 2023
Processing time: 125 Days and 2.5 Hours
Abstract
BACKGROUND

We aimed to investigate the effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) for treating obstructive jaundice (OJ) post hepatoblastoma (HB) surgery (post-HB OJ) by analyzing the data of a case and performing a literature review.

CASE SUMMARY

Clinical data of one patient with post-HB OJ treated by ERCP were retrospectively analyzed. Furthermore, clinical characteristics and insights into the diagnosis and treatment of post-HB OJ in children were summarized via searching various databases and platforms, such as China National Knowledge Infrastructure, Wanfang database, CQVIP database, PubMed, Ringer Link, and Google Scholar. The patient reported herein underwent five chemotherapy sessions after the diagnosis of HB and right hemihepatectomy after tumor size reduction; these were followed by two postoperative chemotherapy sessions. Three months postoperatively, the patient developed icteric sclera, strong tea-colored urine, and clay-like stools, and showed signs of skin itchiness; blood analysis showed significantly an increased conjugated bilirubin (CB) level (200.3 μmol/L). Following the poor efficacy of anti-jaundice and hepatoprotective treatments, the patient underwent ERCP. Intraoperative imaging showed a dilated bile duct in the porta hepatis with significant distal stenosis. A 5 Fr nasopancreatic tube was placed in the dilated area through the stricture for external drainage, and the patient was extubated on postoperative day 6. Postoperatively, the patient’s stool turned yellow, and the CB level decreased to 78.2 μmol/L. Fifteen days later, ERCP was repeated due to unrelieved jaundice symptoms, wherein a 7 Fr nasobiliary drainage tube was successfully placed. Three months post-ERCP, the jaundice symptoms resolved, and the CB level was reduced to 33.2 μmol/L. A follow-up examination one year postoperatively revealed no jaundice symptoms and normal CB level.

CONCLUSION

Post-HB OJ is rare. Compared to biliary tract reconstruction, ERCP is less invasive and has a better therapeutic effect.

Keywords: Endoscopic retrograde cholangiopancreatography; Hepatoblastoma; Pediatric patients; Obstructive jaundice; Case report

Core Tip: This study aimed to investigate the effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of obstructive jaundice following hepatoblastoma surgery by analyzing the data of a case and performing a literature review. We found that ERCP is less invasive and has a better therapeutic effect compared to biliary tract reconstruction.