perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2021-66-5-105-108perinatology-1489Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИCLINICAL CASESСочетанный порок развития желчевыводящих путейCombined malformation of the biliary tracthttps://orcid.org/0000-0001-7594-7723ПисклаковА. В.PisklakovA. V.

Писклаков Андрей Валерьевич (ответственный автор) – д.м.н., проф., зав. кафедрой детской хирургии; руководитель центра патологии репродуктивных органов и тазовой хирургии

644099, Омск, ул. Ленина, д. 12

644043, Омск, Куйбышева, д. 77

Omsk

pisklakovomsk@mail.ruhttps://orcid.org/0000-0002-2746-7079ФедоровД. А.FedorovD. A.

Федоров Денис Александрович – зам. гл. врача по хирургии

644043, Омск, Куйбышева, д. 77

Omsk

https://orcid.org/0000-0003-4075-4037МорозС. В.MorozS. V.

Мороз Сергей Васильевич – зав. 2-м хирургическим отделением

644043, Омск, Куйбышева, д. 77

Omsk

https://orcid.org/0000-0002-2555-7994ПономаревВ. И.PonomarevV. I.

Пономарев Вячеслав Иванович – д.м.н., проф. кафедры детской хирургии

644099, Омск, ул. Ленина, д. 12

Omsk

https://orcid.org/0000-0002-2874-6686ЛысовА. В.LysovA. V.

Лысов Анатолий Васильевич – д.м.н., проф. кафедры детской хирургии

644099, Омск, ул. Ленина, д. 12

Omsk

https://orcid.org/0000-0001-6875-3955ШлычковД. А.ShlychkovD. A.

Шлычков Дмитрий Аркадьевич – врач лучевой диагностики

644043, Омск, Куйбышева, д. 77

Omsk

https://orcid.org/0000-0002-3086-8068ГорлинаА. Ю.GorlinaA. Yu.

Горлина Анна Юрьевна – зав. отделением лучевой диагностики

644043, Омск, Куйбышева, д. 77

Omsk

ФГБОУ ВО «Омский государственный медицинский университет» Минздрава России; БУЗ ОО «Областная детская клиническая больница»РоссияOmsk State Medical University; Regional Children’s Clinical HospitalRussian FederationБУЗ ОО «Областная детская клиническая больница»РоссияRegional Children’s Clinical HospitalRussian FederationФГБОУ ВО «Омский государственный медицинский университет» Минздрава РоссииРоссияOmsk State Medical UniversityRussian Federation202109122021665105108Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20212021Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/1489

Аномалии развития желчевыводящих путей – относительно редко встречающаяся в практике детского хирурга патология. Еще реже встречаются сочетание двух или нескольких пороков билиарного тракта. В статье приведены данные литературы и собственное клиническое наблюдение сочетания кисты общего желчного, или печеночного протока (холедоха) и дополнительного желчного протока у ребенка. Анатомический вариант строения билиарного тракта идентифицирован до операции при использовании магнитно-резонансной холангиографии. На основе анализа данных литературы и собственного наблюдения предлагается алгоритм диагностических мероприятий у детей с пороками развития желчевыводящих путей, позволяющий избежать их интраоперационных повреждений.

Anomalies in the biliary tract development are a relatively rare pathology in the practice of a pediatric surgeon. A combination of two or more defects of the biliary tract is even less common. The article presents literature data and own clinical observation of a child with a combination of a cyst of the common bile, or hepatic, duct (common bile duct) and an additional bile duct. The anatomical structure of the biliary tract was identified before surgery using magnetic resonance cholangiography. Based on the analysis of literature data and our own observation, we propose an algorithm for diagnostic measures in children with malformations of the biliary tract, which helps to avoid intraoperative injuries.

детижелчевыводящие путианомалиикиста общего желчного протока (холедоха)childrenbiliary tractanomaliescommon bile duct cyst (choledoch)ReferencesBhavsar M.S., Vora H.B., Giriyappa V.H. Choledochal cyst: a review of literature. Saudi J Gastroenterol 2012; 18: 230–236. DOI: 10.4103/1319-3767.98425Bhavsar M.S., Vora H.B., Giriyappa V.H. Choledochal cyst: a review of literature. Saudi J Gastroenterol 2012; 18: 230–236. DOI: 10.4103/1319-3767.98425Katabi N., Pillarisetty V.G., DeMatteo R., Klimstra D.S. Choledochal cysts: a clinicopathologic study of 36 cases with emphasis on the morphologic and the immunohistochemical features of premalignant and malignant alterations. Hum Pathol 2014; 45(10): 2107–2114. DOI: 10.1016/j.humpath.2014.06.016Katabi N., Pillarisetty V.G., DeMatteo R., Klimstra D.S. Choledochal cysts: a clinicopathologic study of 36 cases with emphasis on the morphologic and the immunohistochemical features of premalignant and malignant alterations. Hum Pathol 2014; 45(10): 2107–2114. DOI: 10.1016/j.humpath.2014.06.016Soares K.S., Arnaoutakis D.J., Kamel I., Rastegar N., Anders R., Maithel S. et al. Choledochal cysts: presentation, clinical differentiation, and management. J Am Coll Surg 2014; 219(6): 1167–1180. DOI: 10.1016/j.jamcollsurg.2014.04.023Soares K.S., Arnaoutakis D.J., Kamel I., Rastegar N., Anders R., Maithel S. et al. Choledochal cysts: presentation, clinical differentiation, and management. J Am Coll Surg 2014; 219(6): 1167–1180. DOI: 10.1016/j.jamcollsurg.2014.04.023Васильев А.Ю. Магнитно-резонансная холангиография в диагностике заболеваний желчевыводящих путей. Москва: Медицина, 2006; 200.Vasil’ev A.Ju. Magnetic resonance cholangiography in the diagnosis of diseases of the biliary tract. Moscow: Meditsina, 2006; 200. (in Russ.)Lee H.K., Park S.J., Yi B.H., Lee A.L., Moon J.H., Chang Y.W. Imaging features of adult choledochal cysts: a pictorial review. Korean J Radiol 2009; 10: 71–80. DOI: 10.3348/kjr.2009.10.1.71Lee H.K., Park S.J., Yi B.H., Lee A.L., Moon J.H., Chang Y.W. Imaging features of adult choledochal cysts: a pictorial review. Korean J Radiol 2009; 10: 71–80. DOI: 10.3348/kjr.2009.10.1.71Hung M.H., Lin L.H., Chen D.F., Huang C.S. Choledochal cysts in infants and children: experiences over a 20-year period at a single institution. Eur J Pediatr 2011; 170: 1179–1185. DOI: 10.1007/s00431-011-1429-2Hung M.H., Lin L.H., Chen D.F., Huang C.S. Choledochal cysts in infants and children: experiences over a 20-year period at a single institution. Eur J Pediatr 2011; 170: 1179–1185. DOI: 10.1007/s00431-011-1429-2Liu S.L., Li L., Hou W.Y., Zhang J., Huang L.M., Li X. et al. Laparoscopic excision of choledochal cyst and Roux-en-Y hepaticojejunostomy in symptomatic neonates. J Pediatr Surg 2009; 44: 508–511. DOI: 10.1016/j.jpedsurg.2008.08.006Liu S.L., Li L., Hou W.Y., Zhang J., Huang L.M., Li X. et al. Laparoscopic excision of choledochal cyst and Roux-en-Y hepaticojejunostomy in symptomatic neonates. J Pediatr Surg 2009; 44: 508–511. DOI: 10.1016/j.jpedsurg.2008.08.006Edil B.H., Cameron J.L., Reddy S., Lum Y., Lipsett P.A., Nathan H. et al. Choledochal cyst disease in children and adults: a 30-year singleinstitution experience. J Am Coll Surg 2008; 206: 1000–1005. 18471743 DOI: 10.1016/j.jamcollsurg.2007.12.045Edil B.H., Cameron J.L., Reddy S., Lum Y., Lipsett P.A., Nathan H. et al. Choledochal cyst disease in children and adults: a 30-year singleinstitution experience. J Am Coll Surg 2008; 206: 1000–1005. 18471743 DOI: 10.1016/j.jamcollsurg.2007.12.045Ramachandran A., Srivastava D.N., Gupta A.K., Madhusudhan K.S., Ramnarine I.R., Mulpur A.K. et al. The Double Trouble: A Case of Duplicated Extrahepatic Bile Duct with Choledochal Cyst. Indian J Pediatr 2019; 86(2): 186–188. DOI: 10.1007/s12098-018-2790-1Ramachandran A., Srivastava D.N., Gupta A.K., Madhusudhan K.S., Ramnarine I.R., Mulpur A.K. et al. The Double Trouble: A Case of Duplicated Extrahepatic Bile Duct with Choledochal Cyst. Indian J Pediatr 2019; 86(2): 186–188. DOI: 10.1007/s12098-018-2790-1Tahara K., Ishimaru Y., Fujino J., Suzuki M., Hatanaka M., Igarashi A. et al. Association of extrahepatic bile duct duplication with pancreaticobiliary maljunction and congenital biliary dilatation in children: a case report and literature review. Surg Today 2013; 43(7): 800–805. DOI: 10.1007/s00595-012-0262-1Tahara K., Ishimaru Y., Fujino J., Suzuki M., Hatanaka M., Igarashi A. et al. Association of extrahepatic bile duct duplication with pancreaticobiliary maljunction and congenital biliary dilatation in children: a case report and literature review. Surg Today 2013; 43(7): 800–805. DOI: 10.1007/s00595-012-0262-1Prevot F., Rebibo L., Cosse C., Browet F., Sabbagh C., Regimbeau J.M. et al. Effectiveness of intraoperative cholangiography using indocyanine green (versus contrast fluid) for the correct assessment of extrahepatic bile ducts during day-case laparoscopic cholecystectomy. J. Gastrointest Surg 2014; 18(8): 1462–1468. DOI: 10.1007/s11605-014-2560-yPrevot F., Rebibo L., Cosse C., Browet F., Sabbagh C., Regimbeau J.M. et al. Effectiveness of intraoperative cholangiography using indocyanine green (versus contrast fluid) for the correct assessment of extrahepatic bile ducts during day-case laparoscopic cholecystectomy. J. Gastrointest Surg 2014; 18(8): 1462–1468. DOI: 10.1007/s11605-014-2560-ySilva-Baez H., Coello-Ramírez P., Ixtabalán-Escalante E.M., Sotelo-Anaya E., Gallo-Morales M., Cordero-Estrada E. et al. Treatment of choledochal cyst in a pediatric population. A single institution experience of 15-years. Case series. Ann Med Surg (Lond) 2015; 21:5: 81–85. DOI 10.1016/j.amsu.2015.12.054Silva-Baez H., Coello-Ramírez P., Ixtabalán-Escalante E.M., Sotelo-Anaya E., Gallo-Morales M., Cordero-Estrada E. et al. Treatment of choledochal cyst in a pediatric population. A single institution experience of 15-years. Case series. Ann Med Surg (Lond) 2015; 21:5: 81–85. DOI 10.1016/j.amsu.2015.12.054Lee H.K., Park S.J., Yi B.H., Lee A.L., Moon J.H., Chang Y.W. Imaging features of adult choledochal cysts: a pictorial review. Korean J Radiol 2009; 10: 71–80. DOI: 10.1259/bjr/70067143Lee H.K., Park S.J., Yi B.H., Lee A.L., Moon J.H., Chang Y.W. Imaging features of adult choledochal cysts: a pictorial review. Korean J Radiol 2009; 10: 71–80. DOI: 10.1259/bjr/70067143Yoon J.H. Magnetic resonance cholangiopancreatography diagnosis of choledochal cyst involving the cystic duct: report of three cases. Br J Radiol 2011; 84(997): 18–22. DOI: 10.1259/bjr/77844300Yoon J.H. Magnetic resonance cholangiopancreatography diagnosis of choledochal cyst involving the cystic duct: report of three cases. Br J Radiol 2011; 84(997): 18–22. DOI: 10.1259/bjr/77844300

The authors declare that there are no conflicts of interest present.