CLINICAL AND EXPERIMENTAL STUDIES ON THE TREATMENT OF CONGENITAL BILIARY ATRESIA WITH SPECIAL REFERENCE TO THE FACTORS AFFECTING ITS PROGNOSIS

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Biliary reconstruction was performed in 63 among 96 cases of CBA, resulting in observation of good bile excretion in 75.4% of the reconstructed cases. There was no correlation among bile excretion, the age at the time of operation, types of atresia, and results of liver function tests. However, there was a clear relationship between histological findings of the liver and the outcome. Dispite of many cases of good bile excretion, only 8 cases survived for more than 5 years after radical operation. They were operated on at 90 days or less of age and most of them showed slight or moderate intrahepatic fibrosis. Considering from etiology of CBA, histological findings of the liver do not always accord with the age at the time of operation. Therefore, it is dangerous to conjecture the prognosis od CBA on the basis od the age at the time of operation. The obstructive jaundice in infants should be treated as subacute disease. Complication of ascending cholangitis was observed in 79.1% of the operated cases. For the advancement of operative results, seizing of developing state of ascending cholangitis and its preventive countermeasure are necessary. The higher the degree of hepatic damage, the severer becomes the ascending cholangitis due to the decrease of bile flow. resulting in more advanced stage of hepatic damage. The same results were observed in hepatic damaged dogs in which biliary reconstruction was experimentally performed. By endeavoring to do early treatment of CBA and prevention of ascending cholangitis, advancement of the operatory results is expected.
名古屋市立大学の論文
1977-02-28

著者

岡田英也
The 1st Department Of Surgery Nagoya City University Medical School

CLINICAL AND EXPERIMENTAL STUDIES ON THE TREATMENT OF CONGENITAL BILIARY ATRESIA WITH SPECIAL REFERENCE TO THE FACTORS AFFECTING ITS PROGNOSIS

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