胆道閉鎖症 : 胆道再建術式と胆管炎

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During the period from 1970 to 1983, 82 patient underwent portohepatic enterostomy or portohepatic cholecystostomy for the treatment of the biliary atresia. Among which, proper transaction of portal fibrous mass was performed in 60 patients, and 46 of them demonstrated good bile excretion. In this study, 40 patients, who underwent portohepatic enterostomy and had good bile excretion, were devided into two groups. "80cm group" were the group of patients treated with a jejunal loop of 80 cm in length from porta hepatis to the Roux-en-Y anastomosis. "The other group" consists of patients before 1980, who were mainly treated by Kasai's original procedure with a jejunal loop of 40-50cm in length. Of 40 patients, early cholangitis developed in 13 patients, and 9 of them died within 2 years. Early cholangitis strongly indicates the poor prognosis of the patients. In "80 cm group", 2 of 15 patients developed early cholangitis and 2 patients died within 2 years, while in "the other group", 11 of 25 patients developed early cholangitis and 11 patients died within 2 years after operation which indicates that an 80 cm jejunal loop was successfully employed for the prevention of the early cholangitis and for the improvement of the prognosis, combined with a continuous intravenous administration of antibiotics during the first month after operation. Post-operative nutritional evaluation showed no disadvantage in an 80cm jejunal loop procedure.
日本小児外科学会の論文
1988-10-20

胆道閉鎖症 : 胆道再建術式と胆管炎

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