先天性胆道閉鎖症の予後判定についての考察 : とくに ICG 排泄試験と術後の PTC について

概要

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Since 1969 to December 1979, we have treated 69 cases of biliary atresia. Sixteen cases of them have lived over 2 years of age. The analysis by inquirement for mental and physical developments were done in these 16 and one who died at six years of age at home. The percutaneous transhepatic cholangiography (PTC), serum biochemical examination for liver function test and ICG clearance test were performed in fifteen cases at two to nine years of age. From these results, it was found that cases survived more than two years had no retardation of their mental and physical developments. And, ICG clearance test was better parameter for evaluation of liver function when compared to that of serum biochemical examination. On cholangiographic studies, in all 9 cases in whom PTC was successful, partial narrowing, dilatation of the intrahepatic bile duct and the type B cholangiogram, i. e., proliferated bile duct bundle type as classified by us in prevenous report, were observed. Two cases showed partial segmental atrophy of the liver. Therefore, we conclude that cases with biliary atresia having survived long period still show unusual features of the intrahepatic bile duct indicating that continuous efforts for preventing complications such as infection should be made.
特定非営利活動法人日本小児外科学会の論文