Reoperation in the treatment of biliary atresia

Abstract

Rehepatic-portoenterostomy and curettage were performed as reoperative procedures for treatment of biliary atresia. In cases of rehepatic-portoenterostomy, microsurgical technique is an important factor in order to obtain satisfactory operative results. The indication for rehepatic-portoenterostomy, the age of the patient, the size of the intrahepatic bile ducts at the porta hepatis area, the degree of liver fibrosis and liver cell change are closely related to the prognosis of rehepatic-portoenterostomy cases. Since 1977, all seven cases who underwent rehepatic-portoenterostomy showed bile excretion and at present, 3 out of 7 have no jaundice. Curettage is an effective treatment for cessation of bile flow in cases which underwent hepatic portoenterostomy and showed bile excretion for a certain period postoperatively. The timing of curettage is closely related to the results of the curettage. In 9 out of 17 cases which received curettage, we were able to obtain fairly good bile flow and at present, 4 out of 9 show no jaundice.