抄録
Two hundred and thirty-eight patients with biliary atresia were treated at the 2nd Department of Surgery and Pediadric Surgery, Tohoku University Hospital during 31 years from 1953 to 1983 and 214 of them underwent corrective surgery. Since 1971, we have employed several modifications cf Roux-Y hepatic portojejunostomy (a) in order to prevent ascending cholangitis after operation. Main procedures were double Roux-Y hepatic porto-jejunostomy (b) in 68 cases, hepatic porto-jejunostomy with Roux-Y interposition between the porta hepatis and the ducdenum (c) in 12, hepatic porto-cholecystostomy (d) in 12, and conversion from Suruga II to double Roux-Y hepatic porto-jejunostomy (e) in 19. Incidence of postoperative cholangitis was 68% in original Roux-Y hepatic porto-jejunostomy, 56% in b), 100% in c), 0% in d) and 53% in e). Comparing the results of original Roux-Y with those of double Roux-Y procedure, incidence of chclangitis did not decrease markedly, but medical control of it became easier by use of modification. Consequently, the mortality from cholangitis decreased from 47% to 10/0. As another complications in 68 cases with double Roux-Y hepatic porto-jejunostomy, there were 9 intestinal obstruction and 5 leakages of intestinal anastomosis. From these results, we concluded that double Roux-Y modification was not an ideal procedure but was evidently contributing for the progress of surgical results of biliary atresia.
