The Outcome of Surgery for Biliary Atresia: Asan Medical Center (1989~1997).
- Author:
In Koo KIM
;
Dae Yeon KIM
;
Seong Chul KIM
- Publication Type:Original Article
- Keywords:
Biliary atresia;
Portoenterostomy
- MeSH:
Biliary Atresia*;
Chungcheongnam-do*;
Esophageal and Gastric Varices;
Follow-Up Studies;
Heart;
Hemorrhage;
Humans;
Jaundice;
Liver Transplantation;
Sclerotherapy;
Sepsis;
Survival Rate
- From:Journal of the Korean Association of Pediatric Surgeons
1999;5(2):111-115
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The results of hepatic portojejunostomy performed in 34 patients with biliary atresia between May 1989 and December 1997 were analyzed. These patients were divided into three groups based on age of surgery; group 1 (< or =60 days, n = 11); group 2 (61~90 days, n = 14), and group 3 (>90 days, n = 9). Jaundice was cleared in 22 cases (64.7%). There was no significant difference of jaundice-free rate according to the age at operation between group 1, 2, 3. After a mean follow-up period of 33.9 month (range 18days-105.7 month), there were eleven deaths from hepatic failure(6), esophageal varix bleeding even though anicteric(2), sepsis by cholangitis(1), heart failure(1) and renal failure(1). Two of group 1 and 3 had received liver transplantation. With follow-up of average 33.9 months (18days-106months, one follow-up loss), 5-year cumulative survival rate by Kaplan-Meier method was 65.9%. The 5-year survivals of group 1, 2, 3 were 63.6%, 77.9%, 41.4%. There was no significant difference of survival rates according to the age at operation between group 1, 2, 3. Moreover, two cases of group 3 survived more than 5 years. Therefore, hepatic portojejunostomy can be considered as a primary surgical modality for biliary atresia in a patient of 90 days or more. Early detection of esophageal varix and possible sclerotherapy is necessary for long term survival.
