肝門部胆嚢吻合術の問題点についての臨床的検討

抄録

We analysed immediate and late results of 12 biliary atresia patients who underwent hepatic portocholecystostomy. Postoperative cholangitis was not evident after this procedure. Jaundice disappeared in 6 of 12 cases. One of these 6 cases required re-operation by hepatic portojejunostomy before clearance of jaundice, because this patient developed biliary peritonitis after hepatic portocholecystostomy. Five of 6 cases whose corrective operations failed eventually died of hepatic failure. We could not find any relationship between the surgical results and the junctional form of the pancreatic duct and the common bile duct. The clinical problems in jaun-dice-free patients who had this procedure were slow resolution of jaundice and late complication such as portal hypertension. We conclude that, although hepatic portocholecystostomy is effective for prevention of postoperative cholangitis, this procedure is not thought to be the operation of choice for patients with subtype "a" biliary atresia.