Emblem R, Bentsen B, Stake G, Monclair T
Kirurgisk avdeling B, Rikshospitalet, Oslo.
Tidsskr Nor Laegeforen. 1994 Jun 30;114(17):1946-7.
The average survival of patients with biliary atresia that remains untreated is 12 months. Early portoenterostomy, and subsequent liver transplantation if necessary, have improved survival dramatically. The success rate after portoenterostomy is inversely related to age at primary operation, and the results after liver transplantation are best in children who receive the transplant after the age of one year. Thus, early portoenterostomy will buy time and bring the patient into a group with a better prognosis if liver transplantation is performed later. Among infants older than two weeks of age with neonatal jaundice, patients with conjugated hyperbilirubinemia must be identified and referred for investigation. In this case ultrasonography is most important for discovering biliary atresia.
未经治疗的胆道闭锁患者的平均生存期为12个月。早期进行肝门空肠吻合术,必要时随后进行肝移植,已显著提高了生存率。肝门空肠吻合术后的成功率与初次手术时的年龄呈负相关,肝移植的结果在一岁后接受移植的儿童中最佳。因此,如果后期进行肝移植,早期肝门空肠吻合术将争取时间并使患者进入预后较好的群体。在年龄超过两周的新生儿黄疸婴儿中,必须识别出伴有结合胆红素血症的患者并转诊进行检查。在这种情况下,超声检查对于发现胆道闭锁最为重要。