ABSTRACT
Objective To investigate the cause of postoperative pancreatitis in Congenital Biliary Dilatation(CBD), and to explore the preventive measures to decrease its occurrence. Methods Patients with CBD (n=22) were summarized during July 2010-March 2014 in Guiyang children's hospital, which include 8 cases of male, 14 cases of female;Cases that developed postoperative traumatic pancreatitis were taken as experimental group. Cases that did not developed it was used as control group. Ages are from 6 months old to 6 years and 9 months old. All patients were received cyst excision and hepatic duct-jejunum Roux- en- Y anastomosis. All postoperative patients are followed up regularly in clinic and by telephone. All followed up were from 3 months to 3 years with a comprehensive physical examination, routine blood test and urine amy?lase analysis. B-ultrasonic examination was used to understand pancreas recovery as well as the expansion of bile duct in the liver. Results Among the 22 cases, the postoperative 1st and 4th day blood amylase as well as 1st,4th and 7th day urine amylase in the experimental group are all higher than those in the control group with statistical difference ( P < 0.05). Patients in experiment group show low thermal and high leucocyte represent postoperative traumatic pancreatitis. All pa?tients were given trypsin inhibitor and anti-inflammatory treatment who were completely recovered after 4-9 days. All chil?dren growth developed normally, with only 2 cases of raised transaminase which were finally settled. Children showed no pan?creatitis and their ascending cholangitis, upper gastrointestinal angiography revealed no reflux gastritis. Conclusion The patients with CBD should receive surgery-cyst excision, hepatic duct-jejunum Roux-en-Y anastomosis early. During opera?tion, cysts decompression should be applied early. Besides these two procedures, interrupting pancreatic confluence and treat?ing pancreatic enzyme inhibitors postoperative can both help to decrease the occurrence of postoperative traumatic pancreatitis.