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Progress in the treatment of biliary atresia: a plea for surgical intervention within the first two months of life in infants with persistent cholestasis
Author(s) -
Emblem R,
Stake G,
Monclair T
Publication year - 1993
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1993.tb12612.x
Subject(s) - medicine , biliary atresia , extrahepatic biliary atresia , laparotomy , surgery , liver transplantation , jaundice , cholestasis , gallbladder , pediatrics , transplantation , gastroenterology
During the period 1984–1991. 21 infants with biliary atresia were treated with Kasai's portoentcr‐ostorny. The median survival in infants operated on before the age of 60 days (55 (range 5–82) months) was significantly longer than the survival of children operated on after the age of 60 days (15 (1.5 38) months). At present there arc 10 survivors with a median age of 54 (17–96) months: 6 with portoenterostomy and 4 after liver transplantation. Eight patients died of progressive liver failure and 3 died of causes not related 10 biliary atresia. Apart from blood tests, ultrasonography was the most important investigation bcfore laparotomy in infants with cholestatic jaundice. Scintigraphy and liver biopsy added no further decisive information. Because early diagnosis and surgical treatment is important. only the well documented presence of a normal gallbladder can warrant postponement of an operation.