Home intravenous antibiotic treatment for intractable cholangitis in patients with biliary atresia following Kasai portoenterostomies.
10.4174/jkss.2011.80.5.355
- Author:
Jae Ho SHIN
1
;
Eun Young CHANG
;
Hye Kyung CHANG
;
Seong Min KIM
;
Seok Joo HAN
Author Information
1. Division of Pediatric Surgery, Department of Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea. sjhan@yuhs.ac
- Publication Type:Original Article
- Keywords:
Biliary atresia;
Intractable cholangitis;
Home intravenous antibiotics treatment
- MeSH:
Anti-Bacterial Agents;
Biliary Atresia;
Cholangitis;
Hemorrhage;
Hospitalization;
Humans;
Hypertension, Portal;
Inpatients;
Length of Stay;
Liver Cirrhosis, Biliary;
Liver Failure;
Liver Transplantation;
Medical Records
- From:Journal of the Korean Surgical Society
2011;80(5):355-361
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Patients with biliary atresia (BA) treated with Kasai portoenterostomy may later develop intractable cholangitis (IC) that is unresponsive to routine conservative treatment. It may cause biliary cirrhosis and eventually hepatic failure with portal hypertension. Control of IC requires prolonged hospitalization for the administration of intravenous antibiotics. To reduce the hospitalization period, we designed a home intravenous antibiotic treatment (HIVA) which can be administered after initial inpatient treatment. In this study, we reviewed the effects of this treatment. METHODS: We reviewed medical records of 10 patients treated with HIVA for IC after successful Kasai portoenterostomies performed for BA between July 1997 and June 2009. RESULTS: The duration of HIVA ranged from 8 to 39 months (median, 13.5 months). The median length of hospital stay was 5.7 days per month for conventional treatments to manage IC before HIVA and, 1.5 days per month (P = 0.012) after HIVA. The median amount of medical expenses per month was reduced by about one tenth with HIVA. One patient underwent liver transplantation due to uncontrolled esophageal variceal bleeding, but the other nine patients had acceptable hepatic function with native livers. CONCLUSION: HIVA may be an effective primary treatment for IC after Kasai portoenterostomies for BA, and reduce length of hospital stay and medical expense.
