胆道閉鎖症経過良好例における術後減黄に関する検討

概要

論文の詳細を見る
In order to clarify the jaundice clearance pattern immediately after operation for biliary atresia, cases exhibiting both satisfactory post-operative clinical course (total serum bilirubin levels (T-Bil) of 1.0mg/dl or less) and also those exhibiting unsatisfactory progress (postoperative jaundice clearance but T-Bil > 1.0mg/dl) were monitored in terms of their T-Bil. In all cases T-Bil fell to half of the preoperative level within 45 days after operation, irrespective of the satissfactoriness or othewise of postoperative clinical progress, and in the case of the satisfactory clinical course cases T-Bil normalized (< / = 1.0mg/dmg/dl) within 90 days of operation. A comparison with cases of common bile duct dilatation showed the rate of T-Bil reduction to be significantly longer, even amongst the group with satisfactory postoperative clinical progress. Clearly, therefore, there would appear to be intrahepatic cholestasis even in cases where postoperative clinical progress was otherwise satisfactory. These results suggest that the prevention of ascending cholangitis is of paticular importance during the first 3 postoperative months. In cases where T-Bil had failed to normalize more than 90 days after operation, it was assumed that liver transplantation might become necessary at some future point.
日本小児外科学会の論文
1992-12-20