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Surgery Today

, Volume 28, Issue 12, pp 1229–1232 | Cite as

Surgical treatment of biliary atresia in the liver transplantation era

  • Ryoji Ohi
Editorial

Abstract

Biliary atresia (BA) still remains one of the most intractable gastrointestinal diseases in infancy dispite the concerted efforts of pediatric surgeons all over the world. The introduction of liver transplantation has revolutionized the protocols for the treatment of this condition. In this editorial, the role of hepatic portoenterostomy (the Kasai procedure) in the surgical treatment of BA in the “transplantation era” will be discussed.

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References

  1. 1.
    Ohi R, Kasai M, Takahashi T (1969) Intrahepatic biliary obstruction in congenital bile duct atresia. Tohoku J Exp Med 99:129–149CrossRefGoogle Scholar
  2. 2.
    Ohi R, Nio M, Chiba T, Endo N, Goto M, Ibrahim M (1990) Long-term follow-up after surgery for patients with biliary atresia. J Pediatr Surg 25:442–445CrossRefPubMedGoogle Scholar
  3. 3.
    Wood RP, Langnas AN, Stratta RJ, Pillen TJ, Williams L, Lindsay S, Meiergerd D, Shaw BW Jr (1990) Optimal therapy for patients with biliary atresia: portoenterostomy (“Kasai” procedures) versus primary transplantation. J Pediatr Surg 25:153–162CrossRefPubMedGoogle Scholar
  4. 4.
    Sandler AD, Azarow KS, Superina RA (1997) The impact of a previous Kasai procedure on liver transplantation for biliary atresia. J Pediatr Surg 32:416–419CrossRefPubMedGoogle Scholar
  5. 5.
    Dunn SP, Weintraub W, Vinocur CD, Billmire DF, Falkenstein K (1993) Is age less than 1 year a high-risk category for orthotopic liver transplatation? J Pediatr Surg 28:1048–1050CrossRefPubMedGoogle Scholar
  6. 6.
    Inomata Y, Tanaka K, Okajima H, Uemoto S, Ozaki N, Egawa H, Satomura K, Kikuchi T, Yamaoka Y (1996) Living related liver transplantation for children younger than one year old. Eur J Pediatr Surg 6:148–151CrossRefPubMedGoogle Scholar
  7. 7.
    Ohi R, Shikes RH, Stellin GP, Lilly JR (1984) In biliary atresia duct histology correlates with bile flow. J Pediatr Surg 19:467–470CrossRefPubMedGoogle Scholar
  8. 8.
    Tan CE, Davenport M, Driver M, Howard ER (1994) Does the morphology of the extrahepatic biliary remnants in biliary atresia influence survival? A review of 205 cases. J Pediatr Surg 29:1459–1464CrossRefPubMedGoogle Scholar
  9. 9.
    Segawa O, Miyano T, Fujimoto T, Watanabe S, Hirose M, Fujiwara T (1993) Actin and myosin deposition around bile canaliculi: a predictor for clinical outcome in biliary atresia. J Pediatr Surg 28:851–856CrossRefPubMedGoogle Scholar
  10. 10.
    Hossain M, Murahashi O, Ando H, Iio K, Kaneko K, Ito T (1995) Immunohistochemical study of proliferating cell nuclear antigen in hepatocytes of biliary atresia: a parameter to predict clinical outcome. J Pediatr Surg 30:1297–1301CrossRefPubMedGoogle Scholar
  11. 11.
    Kobayashi H, Puri P, O'Briain DS, Surana R, Miyano T (1997) Hepatic overexpression of MHC class II antigens and macrophage-associated antigens (CD68) in patients with biliary atresia of poor prognosis. J Pediatr Surg 32:590–593CrossRefPubMedGoogle Scholar
  12. 12.
    Wanek EA, Horgan JG, Karrer FM, Hall RJ, Pumack CM, Lilly JR (1990) Portal venous velocity in biliary atresia. J Pediatr Surg 25:146–148CrossRefPubMedGoogle Scholar
  13. 13.
    Fujimoto M, Ohya T, Miyano T (1994) A new clinical prognostic predictor for patients with biliary atresia. J Pediatr Surg 29:757–760CrossRefPubMedGoogle Scholar
  14. 14.
    Davenport M, Howard ER (1996) Macroscopic appearance at portoenterostomy—a prognostic variable in biliary atresia. J Pediatr Surg 31:1387–1390CrossRefPubMedGoogle Scholar
  15. 15.
    Azarow KS, Philips MJ, Sandler Ad, Hagerstrand I, Superina RA (1997) Biliary atresia: should all patients undergo a portoenterostomy? J Pediatr Surg 32:168–174CrossRefPubMedGoogle Scholar
  16. 16.
    Shimaoka S, Ohi R, Nio M, Iwami D, Sano N (1997) Clinical significance of99mTc-DTPA galactosyl human serum albumin scintigram in follow-up after Kasai operation. Tohoku J Exp Med 181:203–211CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 1998

Authors and Affiliations

  • Ryoji Ohi
    • 1
  1. 1.Department of Pediatric SurgeryTohoku University School of MedicineSendaiJapan

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