Simultaneous pancreaticoduodenectomy and liver transplantation for biliary atresia complicated by choledochal cyst

Abstract

Children with biliary atresia (BA), a progressive, fibro-obliterative disorder of the intrahepatic and extrahepatic bile ducts in neonates will eventually develop decompensated cirrhotic liver and require liver transplantation (LT). Choledochal cysts (CCs), congenital dilatations of the bile ducts that may be either extrahepatic and/or intrahepatic, should be excised in case that the biliary system cancer might occur. We report here a case of simultaneous pancreaticoduodenectomy (PD) performed simultaneously with liver transplantation in a 4 months old infant using a whole graft from deceased donor after heart arrest. The post-operation recovery was uneventful and the patient was discharged 32 days after the procedure. Currently, 2 months after OLT, the patient is doing well with no evidence of complications. In conclusion, a simultaneous PD with OLT is a safe and feasible option to treat CCs complicating BA. Long-term follow-up and accumulation of cases are necessary to evaluate the effectiveness of this procedure for this complicated disease.

Keywords

• Pancreaticoduodenectomy
• Biliary atresia
• Choledochal cyst
• Liver transplantation