胆道闭锁成功手术修复后发生的上行性胆管炎。
Ascending cholangitis after successful surgical repair of biliary atresia.
作者信息
Kobayashi A, Utsunomiya T, Obe Y, Shimizu K
出版信息
Arch Dis Child. 1973 Sep;48(9):697-703. doi: 10.1136/adc.48.9.697.
Abstract
Since the introduction of hepatic porto-enterostomy, encouraging results have been obtained in treating extrahepatic biliary atresia, particularly in the case of infants with atresia or agenesis of the extrahepatic ducts, who would not previously have been considered amenable to surgery. Out of 17 successfully repaired cases who had shown good bile excretion after surgery and who had no jaundice, 8 (47%) developed ascending cholangitis 3½ to 8½ months after surgery. Cholangitis of this type formed a recognizable picture, with repeated attacks of fever, reappearance of obstructive jaundice, raised erythrocyte sedimentation rate, leucocytosis with shift to the left, and anaemia. The condition was often resistant to antibiotic therapy, and was fatal in 3 cases.
摘要
自从采用肝门肠吻合术以来，在治疗肝外胆管闭锁方面已取得了令人鼓舞的成果，特别是对于那些以前被认为不适合手术的肝外胆管闭锁或发育不全的婴儿。在17例手术后胆汁排泄良好且无黄疸的成功修复病例中，8例（47%）在术后3个半月至8个半月发生了上行性胆管炎。这种类型的胆管炎呈现出一种可识别的症状，包括反复发热、梗阻性黄疸再次出现、红细胞沉降率升高、白细胞增多伴核左移以及贫血。这种情况对抗生素治疗往往耐药，并有3例死亡。
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