Reoperation for Jaundiced Patients after Initial Hepatic Portoenterostomy for Biliary Atresia

Abstract

The aim of this study was to evaluate the optimal timing of reoperation for patients with biliary atresia (BA). Twelve patients with BA underwent reoperation after hepatic portoenterostomy (HPE) between May 1993 and November 2011 at our institution. They were divided into two groups. Group A patients showed no benefit from the reoperation. Group B patients became jaundice-free after the reoperation. Medical records were retrospectively reviewed. Six of the twelve patients became jaundice-free after reoperation (Group B). No significant differences were seen in jaundice-free ratio (JFR), body weight at reoperation and the interval between HPE and reoperation. The serum total bilirubin (T.bil) and direct bilirubin (D.bil) levels before reoperation in Group B were significantly lower than those in Group A. T.bil and D.bil levels before reoperation were these important to determine the timing of reoperation. It is difficult for a case to become jaundice-free when the T.bil level is over 9.0mg/dl or the D.bil level is over 7.5mg/dl.