Otte J B, Eucher P, Latour J P, de Ville de Goyet J, Yandza T, de Hemptinne B, Kestens P J
Department of Paediatric Surgery, University of Louvain Medical School, Brussels, Belgium.
Z Kinderchir. 1988 Apr;43(2):99-105. doi: 10.1055/s-2008-1043426.
This report reviews the results of some paediatric surgical departments and points out the unsolved problems in biliary atresia disease. The authors conclude that a 5-year survival rate of 60% may be achieved in long-term follow-up, but a complete cure is observed only in 30%. Children who develop a cirrhosis and portal hypertension without or in spite of bile flow can benefit only by liver transplantation. As a result of long-term clinical experience conditions are defined that should be taken in consideration in the surgical treatment of bile duct atresia. In respect of liver transplantation the disadvantages of an external bile draining fistula to prevent cholangitis, an extensive mobilisation of the liver for HPE procedure, and the disadvantages of reoperation are discussed. By avoiding these disadvantages liver transplantation procedure will be facilitated and a 1-2 year survival rate of 80% may be achieved.
本报告回顾了一些儿科外科部门的成果，并指出了胆道闭锁疾病中尚未解决的问题。作者得出结论，长期随访中5年生存率可能达到60%，但仅有30%能实现完全治愈。出现肝硬化和门静脉高压且无胆汁流动或尽管有胆汁流动但仍出现上述情况的儿童，仅能通过肝移植获益。基于长期临床经验，明确了在胆管闭锁手术治疗中应考虑的条件。关于肝移植，讨论了为预防胆管炎而进行的外部胆汁引流瘘的缺点、为肝门空肠吻合术而广泛游离肝脏的缺点以及再次手术的缺点。通过避免这些缺点，肝移植手术将得到简化，1至2年生存率可能达到80%。
