Lilly J R, Altman R P
Surgery. 1975 Jul;78(1):76-86.
Twenty-two infants and children with extrahepatic biliary atresia were treated by Kasai's hepatic portoenterostomy operation since 1972. Postoperative bile drainage occurred in 11 infants. Success never was obtained in patients older than 12 weeks nor in the absence of microscopic biliary ductules in the excised fibrotic remnant of the extrahepatic bile ducts. With these exclusions almost 90 percent of infants with biliary atresia had sustained bile drainage after operation. In the early cases, ascending cholangitis was a major and recurrent complication with sequellae in many instances of permanent jaundice and probably irreversible liver damage. A new and simple modification of Kasai's original operation has prevented this complication thus far. Despite apparently normal bile drainage, postoperative studies by transhepatic cholangiography in some of these patients have demonstrated a grossly abnormal hepatobiliary intrastructure, suggesting that an underlying liver involvement may be present in biliary atresia.
自1972年以来，22例患有肝外胆道闭锁的婴幼儿接受了Kasai肝门肠吻合术治疗。11例婴儿术后出现胆汁引流。12周龄以上的患者或在切除的肝外胆管纤维化残余物中没有微小胆管的患者从未获得成功。排除这些情况后，几乎90%的胆道闭锁婴儿术后持续有胆汁引流。在早期病例中，上行性胆管炎是主要的复发性并发症，在许多情况下会导致永久性黄疸后遗症和可能不可逆转的肝损伤。Kasai原始手术的一种新的简单改良方法至今已预防了这种并发症。尽管胆汁引流明显正常，但其中一些患者经肝胆管造影术后研究显示肝胆内部结构严重异常，提示胆道闭锁可能存在潜在的肝脏受累情况。
