胆道閉鎖症における葛西手術術後の経過と肝移植の適応

概要

論文の詳細を見る
This study is a review of our patients with biliary atresia for determination of predictability in prognosis after Kasai procedure in terms of liver transplantation. Sixty-six patients who have undergone kasai procedure for biliary atresia durng a period from 1971 through 1981 were subjected to this study. Fifty-six had a bile drainage and the remaining 10 did not. Seventeen became anicteric with serum bilirubin below 1.0mg% during 6 months after operation and have been free of jaundice for 3-12 years. In 9 patients with delayed subsidence of jaundice, only 4 surviyed. Twelve of the remaining 26 deaths were due to hepatic disorders aggravated by cholangitis. A constant increase of serum bilirubin was characteristic in this group and all died in one year after serum bilirubin reached 10mg%. This study has suggested : (1) determination of serum bilirubin at 6 months after operation is an important index for future course, (2) liver transplantation should be urgently considered for those with recurrent jaundice with constant increase of serum bilirubin exceeding 10mg%, (3) those with an absence of initial bile drainage or with deterioration of hepatic disorder at 6 months after operation be candidates of liver transplantation.
特定非営利活動法人日本小児外科学会の論文
1986-05-20