ENDOSCOPIC SPHINCTEROTOMY AND LAPAROSCOPIC CHOLECYSTECTOMY IN AN INFANT WITH CHOLECYSTOCHOLEDOCHOLITHIASIS

Laparoscopic cholecystectomy (LC) and endoscopic sphincterotomy (EST) are widely accepted procedures for cholecysto-choledocholithiasis in a dults. However, their use in infants has not been reported. An 8-month -old girl presented with high fever and obstructive jaundice. Ultrasou nd scan showed acute cholecystitis with stones in the bile duct. After 2-week-long antibiotic therapy the acute cholecystitis and hepatic im pairment resolved. An endoscopic retrograde cholangiopancreatography ( ERCP) confirmed choledocholithiasis and cholecystolithiasis. Risk fact ors for the development of biliary calculi were not detected. One mont h after the restoration of her liver function, she underwent EST using a side-viewing endoscope with a small sphincterotome. A common bile d uct stone was extracted using a basket catheter. LC was then carried o ut. The time interval between the EST and LC was 34 days. No complicat ions have been noted for 6 months. Copyright (C) 1998 by W.B. Saunders Company.