CLINICAL STUDY OF ASCENDING CHOLANGITIS FOLLOWING PORTOJEJUNOSTOMY FOR BILIARY ATRESIA

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  • 胆道閉鎖症の肝門部空腸吻合術後に生じる胆管炎の臨床的検討

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Abstract

To evaluate the clinical features of ascending cholangitis (AC) following portojejunostomy for biliary atresia, 77 cases of AC treated at Gunma Children's Medical Center were studied retrospectively.<BR>The results were as follows : (1) Most of the AC occurred within 2 years after the operation. (2) The group with a recurrence of jaundice and the group operated on more than 41 days afterbirth had a high incidence of AC. (3) Over half of the cases, which had both high fever and a decrease in bile flow, developed jaundice soon thereafter. (4) In twenty-four out of 46 AC, AC recurred within 1-2 months, the decreased bile flow persisted. (5) AC occurring within 2 years after the operation, the group without recurrence of jaundice, and the group operated on within40 days after birth could almost all be treated medically. (6) The effectiveness of medical treatment was not correlated with the degree of jaundice accompanying the AC. (7) Some of the AC cases were effectively treated by surgical methods.<BR>These findings indicate that early diagnosis and surgery of biliary atresia prevents the occurrence of AC, and that active examination and treatment for AC is necessary when a high fever and a decrease in bile flow occur, especially within 2 years after the operation.

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