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KMID : 0371319840270010121
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Journal of the Korean Surgical Society
1984 Volume.27 No. 1 p.121 ~ p.124
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Prevention of Acute Cholangitis in Neonatal Biliary Atresia
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Abstract
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Long term survival without jaundice from biliary atresia were achieved in our service by thealteration of surgical technique in 19801981 period. Ten patients from twenty three biliary atresia are living without jaundice over three years. There were ten biliary atresia without any survival in 1978-1979 period.
These alterations were:
1) Level of the transection of fibrotic mass at hilum.
78~79 period: at the level of bifurcation of portal vein
80~81 period: well above the bifurcation, posterior surface of the portal vein, with ligation . of small veins from the portal vein.
2) Intestinal conduit
78~79 period: Roux-en-Y hepatic portoenterostomy (Kasai I) with 40cm loop 80~81 period: Kasai I with 60cm loop
Statistical analysis revealed that severe cholangitis play decisive role on the mortality (P[Z) <0.0001). But change in the mode of intestinal conduit did not show difference in the incid-ence of cholangitis (P(Z)>0.05).
In our series, the mode of intestinal conduit have less impact on the prevention of cholang-itis than the proper level of transection of the fibrotic mass at the porta hepatis.
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