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Abstract
Ten patients with surgically correctable extrahepatic biliary atresia have undergone
surgical biliary-enteric drainage at the UCLA Hospital during the past 16 years. During
the same period, 39 additional patients underwent biopsy or other operative procedures
for intrahepatic atresia. Three categories of “correctable” atresia are identified:
Type A with a large cystic dilatation of the proximal duct; Type B with a moderately
dilated proximal common duct measuring 4 to 12 mm. in diameter; and Type C with a
blindly ending proximal duct less than 3 mm. in diameter. The prognosis for long-term
survival with resolution of cirrhosis is good in patients with Types A and B atresia,
provided biliary-enteric drainage is established before the age of four months. Five
of the eight patients in the present study who underwent biliary-to-intestinal anastomosis
before the age of four months are still alive and well. Choledochojejunostomy is less
likely to be complicated by obstruction or cholangitis than is drainage to the duodenum.
Patients with Type C atresia may occasionally benefit from jejunal anastomosis to
the hepatoduodenal ligament if performed before the age of three months. A few patients
may have a combination of intrahepatic and extrahepatic atresia.
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References
- Congenits biliary atresia.Br. Med. J. 1960; 2: 1253
- Extrahepatic biliary atresia: Further comments on potentially operable cases.J. Pediatr. Surg. 1968; 3: 584
- Reversibility of biliary cirrhosis due to bile duct obstruction.J. Pediatr. Surg. 1971; 6: 256
- Hepatic lymphatic drainage to the jejunum for congenital biliary atresia.Am. J. Surg. 1966; 112: 188
- Lifespan in untreated biliary atresia.Surgery. 1963; 54: 373
- Surgical treatment of biliary atresia.J. Pediatr. Surg. 1968; 3: 665
- Congenital obstruction of the bile ducts.Ann. Surg. 1935; 102: 742
- Congenital extrahepatic biliary atresia.Arch. Surg. 1972; 105: 771
- Liver and biliary tract.in: Mustard W.T. Ravitch M.M. Snyder Jr., W.H. Pediatric surgery. Year Book Medical Publishers, Chicago, Ill1969: 732
- A follow-up study of prolonged obstructive jaundice in infancy.Pediatr. Univ. Tokyo. 1966; 12: 41
- A clinical and pathological study of congenital biliary atresia.J. Pediatr. Surg. 1972; 7: 655
- Studies in neonatal hepatitis and biliary atresia. IV. Diagnosis.Am. J. Dis. Child. 1968; 116: 280
Article info
Publication history
Accepted:
October 10,
1973
Footnotes
☆Supported by the United States Public Health Service Grant No. HL 14333.
☆☆Presented at the Sixth Annual Meeting of the Pacific Association of Pediatric Surgeons, San Diego, Calif., April 18–20, 1973.
Identification
Copyright
© 1974 Published by Elsevier Inc.
