Advances in pediatric surgery

Korean Association of Pediatric Surgeons (대한소아외과학회)
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Hepatic Portojejunostomy for Biliary Atresia

담도폐쇄증에서 간문부-장 문합술의 성적

  • Kim, In-Koo (Division of Pediatric Surgery, Department of Surgery, University of Ulsan, College of Medicine and Asan Medical Center) ;
  • Kim, Dae-Yeon (Division of Pediatric Surgery, Department of Surgery, University of Ulsan, College of Medicine and Asan Medical Center) ;
  • Kim, Seong-Chul (Division of Pediatric Surgery, Department of Surgery, University of Ulsan, College of Medicine and Asan Medical Center)
  • 김인구 (울산대학교 의과대학 외과학교실, 소아외과) ;
  • 김대연 (울산대학교 의과대학 외과학교실, 소아외과) ;
  • 김성철 (울산대학교 의과대학 외과학교실, 소아외과)
  • Published : 1999.12.30
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Abstract

The results of hepatic portojejunostomy in 34 patients with biliary atresia operated upon by one surgeon between May 1989 and December 1997 were analyzed. Eleven (32.3 %) patients were 60 days or younger, 14 patient (41.2 %) were between 60 and 90 days, and 9 (26.5 %) were over 90 days of age. Jaundice cleared in 20 cases (58.8 %). Three patients died of liver insufficiency, 2 were anicteric but died from esophageal variceal bleeding. Three patients died as a result of sepsis, heart failure and left kidney agenesis. Five patients were lost to follow-up. The five-year survival rate was 73.8 %. Two patients over 90 days of age, survived more than 5 years. Survival rates were not significantly related to the age at operation. We conclude that hepatic portojejunostomy should be considered as a primary surgical modality for biliary atresia, even at age 90 days or more. Early detection of esophageal varices and sclerotherapy may be necessary. Liver transplantation is necessary if hepatic failure develops.

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