Button cholecystostomy for management of progressive XXXX .

@entity1 @entity294 @entity254 @entity1003 @entity111 @entity1578 @entity1448 @entity6741 @entity3147 @entity253 @entity204 @entity9744 @entity255
BACKGROUND/PURPOSE: Progressive @entity9744 are characterized by impaired @entity6741 secretion resulting in @entity111 , @entity1003 , @entity294 , and @entity3147 leading to progressive @entity1578 and @entity204 in childhood. Partial internal or external biliary drainage can relieve symptoms and slow the progression of the disease. Objections to partial external biliary drainage include the need for a permanent @entity253 with all the inherent complications of a stoma. We propose a novel approach to these diseases--placement of a "button" cholecystostomy tube. METHODS: Under general anesthesia and through a small right subcostal incision, a MIC-KEY button (Kimberly-Clark Worldwide, Inc, Draper, UT) is inserted into the mobilized fundus of the gallbladder and secured with 2 purse-string sutures. Time of drainage is adjusted to relieve @entity111 . RESULTS: Three @entity1 with progressive familial intrahepatic @entity1448 achieved adequate bile drainage via the cholecystostomy button to relieve @entity111 for 1, 2, and 2    years postoperatively, with drainage periods of 12 to 14 hours per day. There were no episodes of @entity255 . Dislodged tubes can be replaced, or stones can be retrieved via the tract that is formed. @entity1 (parent) acceptance has been excellent. CONCLUSION: Button cholecystostomy is simple to perform, relieves @entity111 with intermittent (nighttime) drainage, avoids complications of a permanent stoma, avoids an enteric @entity254 , and is accepted by parents.
