Abstract
Biliary atresia (BA) and congenital choledochal malformations (CCM) are rare. Both
pathologies must (BA) or may (CCM) be operated during the neonatal period or early
infancy. We briefly describe the classical operative techniques for both pathologies,
followed by the most common and severe perioperative complications encountered during
and up to 30 days after surgery in children operated for BA and CCM early in life.
For patients with BA, intestinal complications represent the most common and hazardous
perioperative surgical complications. Cholangitis is the most frequently encountered
medical complication post hepato-porto-enterostomy. For CCM, it seems that neonates
encounter little perioperative complications; however, reports are scarce; bile leak
and/or cholangitis are the most reported. Overall, for patients with CCM, the literature
is ambivalent whether more perioperative complications occur in the younger or in
the older patient, and whether these occur more frequently in those symptomatic or
asymptomatic at operation. It is difficult to give clear advice for when children
with asymptomatic CCM should be operated, and benefits and risks must be carefully
counterbalanced. Perioperative mortality for both BA and CCM is low and is reported
to be around 1 to 2%.
Keywords
biliary atresia - congenital choledochal malformations - complications - surgery
