BILIARY ATRESIA: REVIEW OF EXPERIENCE WITH TWENTY‐THREE PATIENTS

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Abstract
Prior to the Kasai procedure of hepatic porto-enterostomy in 1959, biliary atresia was a bleak chapter in pediatric surgery. It was only after many years, however, that the procedure became widely accepted. During the past 8 yr, 23 cases of biliary atresia were treated at the Royal Alexandra Hospital for Children [Sydney, Australia]. Twenty-one had the noncorrectable type of atresia. Sustained drainage was obtained in 10 patients, all of whom had the noncorrectable type anomaly. Nine are still alive, 8 having survived > 1 yr after operation and all are free from jaundice. Cholangitis has been a problem in 6 of these patients and 6 have evidence of fibrosis or cirrhosis on subsequent liver biopsy. Two patients have shown improvement in liver histology since operation. Sustained biliary drainage is related to age at operation, the size of biliary ductules at the porta and the subsequent development of cholangitis. Long term prognosis still remains uncertain.

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