Biliary atresia, an analysis of 30 cases

Abstract

Of 30 cases of extrahepatic biliary atresia, treated during 1973–81, twenty five were males and five were females. Two thirds of these were admitted after 90 days of age. A correct pre operative diagnosis was made in 28 patients. Wedge liver biopsy and operative cholangiograms were done in all cases. Various types of drainage procedures done in 20 patients included hepatic porto- enterostomy 13, hepatic porto- cholecystostomy 4, choledochojejunostomy 2 and choledochoduodenostomy 1. Since 1980, an operating microscope had been used for the dissection at porta hepatis.

Free flow of bile from dissected porta hepatis was observed n 14 patients (70%); 8 of them were more than three months of age. In 2 cases, in whom hepatic porto- cholecystostomy was done, bile flow stopped after some time. There were three post operative deaths due to Klebsella sepsis. At 6 to 24 months follow up, symptoms improved in 12 patients (60%). Seven of them (35%) being completely free from jaundice while 2 of these developed portal hypertension and died of haemetemesis. Mild attacks of cholangitis have been managed conservatively in 10 patients (50%).