Hepatic Portojejunostomy for Biliary Atresia

=

Abstract

=

Hepatic Portojejunostomy for Biliary Atresia

In Koo Kim, M.D., Dae-Yeon Kim, M.D., Seong Chul Kim, M.D.

Division of Pediatric Surgery, Department oj Surgery, University of Ulsan, College of Medicine and Asan Medical Center

Seoul, Korea

The results of hepatic portojejunostomy in

34

patients with biliary atresia operated upon by one surgeon between May 1989

and

December 1997 were analyzed. Eleven

(32.3 %)

patients were 60 days

or

younger, 14 patient (41.2

%)

were between 60 and 90 days, and 9 (26.5

%)

were over 90 days of age. Jaundice cleared in 20 cases

(58.8 %).

Three patients died of liver insufficiency, 2 were anicteric but died from

esophageal

variceal bleeding. Three patients died

as a

result of sepsis, heart failure

and

left kidney

agenesis.

Five patients were lost to follow-up. The five-year

survival

rate was 73.8

%.

Two patients over 90 days

of

age, survived more than

5 years.

Survival rates were not

significantly

related to the age at operation. We conclude that hepatic portojejunostomy

should

be considered as a primary

surgical

modality for biliary atresia, even at age 90 days or more. Early detection of esophageal varices and

sclerotherapy

may be necessary.

Liver

transplantation is necessary if hepatic failure develops.

Index Words: Biliary atresia, Portoenterostomy

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Correspondence: In Koo Kim, M.D., Division of Pediat- ric Surgery, Department of Surgery, University of Ulsan, College of Medicine and Asan Medical Center, 388-1 Pun/?nap-don/?, SOIl/?pa-/?u, Seoul 138-736 Korea

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