Schweizer P
Zentralbl Chir. 1979;104(21):1413-23.
In the treatment of extrahepatic biliary atresia Kasai's hepatic-porto-enterostomy brought an important improvement. A bile drainage from the liver into the bowel can be achieved in about 40% of the children suffering from extrahepatic bile duct atresia. Long-term results are nevertheless disappointing because cholangitis and the progression of fibrosis and the original disease aggravate the final results. Supported by the results of animal experiments and clinical findings we studied the possibility of bile drainage together with the hepatic lymph into the bowel. In the animal experiments we succeeded in developing a successful method. The method of operation is described and reasons are mentioned. The first clinical results achieved with a small number of patients are reported and some open questions are put up for discussion.
在肝外胆管闭锁的治疗中,Kasai肝门肠吻合术带来了重要进展。约40%患有肝外胆管闭锁的儿童可实现胆汁从肝脏引流至肠道。然而,长期结果令人失望,因为胆管炎、纤维化进展以及原发病会使最终结果恶化。在动物实验结果和临床发现的支持下,我们研究了将胆汁与肝淋巴一起引流至肠道的可能性。在动物实验中,我们成功开发出一种可行的方法。描述了手术方法并阐述了原因。报告了少数患者取得的首批临床结果,并提出一些有待讨论的开放性问题。