López Pérez G, Gomezese S, de la Cruz R, Echeverry J, Azcárate J, Unda A
Cir Pediatr. 1989 Apr;2(2):55-7.
Kasai's procedure has changed significantly the prognosis of biliary atresia. However, ascending cholangitis is a relatively frequent postoperative complication with high morbidity and mortality rates. We have developed a modification of that technic consisting in the isolation of a segment of jejunum-with its blood supply carefully preserved, after fashioning an antireflux valve in its distal end. This segment of bowel, less than 10 cm. in length, is anastomosed to the porta hepatis proximally and to the duodenum distally. Using this technic, we have operated upon three infants with biliary atresia and a child with extended rabdosarcoma of the biliary tree. After a follow up of 10 to 17 months with an average of 12.5 months, all children remain free of cholangitis and two of them are anicteric.
肝门空肠吻合术已显著改变了胆道闭锁的预后。然而,上行性胆管炎是一种相对常见的术后并发症,其发病率和死亡率都很高。我们对该技术进行了改良,即在空肠远端制作一个抗反流瓣膜后,分离一段保留其血供的空肠。这段长度小于10厘米的肠段,近端与肝门吻合,远端与十二指肠吻合。运用该技术,我们为3例胆道闭锁患儿和1例患有胆管广泛性横纹肌肉瘤的儿童进行了手术。在平均随访12.5个月(随访时间为10至17个月)后,所有患儿均未发生胆管炎,其中2例黄疸消退。