Inclease of long-term survivors after successful hepatic portoenterostomy for biliary atresia now confronts pediatric surgeons with another problem, portal hypertension. From 1953 through 1984, 225 cases of biliary atresia have been operated and 95 patients are surviving. Portal hypertension with esophageal varices was endoscopically confirmed in 26 of 72 patients examined and classified according to the criteria proposed by Japanese Commities on Portal Hypertension. Nine endoscopic examinations were performed at radical operation and esophageal varices could not be detected. Esophageal varices were found in 4 patients under 1 year old. All these patients were complicated with cholangitis and the complication of cholangitis during the postoperative course is a significant factor for development of portal hypertension. Variceal bleeding occured in 7 cases of 26 esophageal Varices. Red-color sign in the most significant funding relating to variceal homorrage. It will be concluded that the the serial endoscopic examinations in the postoperative courses are most important for an appropriate management of portal hypertension developed in some cases of this disease.
