Hepatic portoenterostomy—Is it indicated in the treatment of biliary atresia?

Campbell, David P.; Poley, J. Rainer; Bhatia, Mira; Smith, E. Ide

doi:10.1016/s0022-3468(74)80288-5

Cited by 26 publications

(4 citation statements)

References 4 publications

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“…The disappointing results of surgical intervention, including portoenterostomy, in this series are similar to those recently reported by Campbell et al (1974a). Ineffective surgery in this series did not cause increased morbidity or significantly earlier death.…”

Section: Discussionsupporting

confidence: 88%

“…Only 5 % of cases have distal obstructions with patent bile-containing proximal bile ducts which allow bile drainage by standard surgical techniques (Arima, Fonkalsrud, and Neerhout, 1974). Many of these will have developed cirrhosis by early childhood, though occasional cases survive to adulthood (Berenson, Garde, and Moody, 1974).The remaining 95 % usually die by the age of 2 years (Campbell et al, 1974a), though the operation of hepatic portoenterostomy introduced in Japan 15 years ago by Kasai and co-workers has given …”

mentioning

confidence: 99%

“…The remaining 95 % usually die by the age of 2 years (Campbell et al, 1974a), though the operation of hepatic portoenterostomy introduced in Japan 15 years ago by Kasai and co-workers has given…”

mentioning

confidence: 99%

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Extrahepatic biliary atresia versus neonatal hepatitis. Review of 137 prospectively investigated infants.

Mowat¹,

Psacharopoulos²

1976

Archives of Disease in Childhood

123

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R. (1976). Archives of Disease in Childhood, 51, 763. Extrahepatic biliary atresia versus neonatal hepatitis: review of 137 prospectively investigated infants. In a prospective regional survey of neonatal hepatitis syndrome 32 infants had extrahepatic biliary atresia (EHBA) and 103 had hepatitis. No cause for the lesion was found in infants with extrahepatic biliary atresia, but in 32 with hepatitis a specific cause was identified, 24 having genetic deficiency of the serum protein oc1-antitrypsin. No differences were observed in parental age, mother's health in pregnancy, month of birth, birth order, or sex of the infants. Familial idiopathic hepatitis occurred in 3 of 67 sibs of patients with idiopathic hepatitis, but the 33 sibs of EHBA patients had no liver disease. Of the infants with hepatitis, 36 were of low birthweight, <2-5 kg, and 23 were born prematurely. Infants with biliary atresia were all of normal birthweight and only one was born prematurely.Consideration of clinical and biochemical abnormalities in the first 2 months of life showed no differences between the two groups except that infants with EHBA were more commonly jaundiced from birth (80%) and had more frequently acholic stools (83%). The frequency of these features in patients with hepatitis being 68% and 52%. Standard tests of liver function were not discriminatory. Percutaneous liver biopsies were diagnostic in 75 % of those with EHBA and in 92% of those with hepatitis. The 131I Rose Bengal faecal excretion was less than 10°/o in 26 of 28 infants with EHBA and in only 5 of 18 with hepatitis. These latter two investigations together allowed a correct preoperative diagnosis of EHBA in all instances. Bile drainage was achieved surgically in only 3 cases. A major reason for these poor results may have been the late referral of cases for diagnosis and laparotomy, which should be performed as soon as the diagnosis is suspected and always by 70 days of age.

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Section: Discussionsupporting

confidence: 88%

mentioning

confidence: 99%

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Extrahepatic biliary atresia versus neonatal hepatitis. Review of 137 prospectively investigated infants.

Mowat¹,

Psacharopoulos²

1976

Archives of Disease in Childhood

123

View full text Add to dashboard Cite

show abstract

“…Without surgical repair, the prognosis of both groups is grave with a 99% chance of death by 2 years of age (23). In the first portoenterostomy series, Campbell et al reported 100% mortality at an average time of 15.3 months after the operation (24). Very similar results were reported in the early reports from the United Kingdom and United States (7,25).…”

Section: Extrahepatic Biliary Atresiamentioning

confidence: 63%