Effectiveness of an intussusceptive antireflux valve to prevent ascending cholangitis after hepatic portojejunostomy in biliary atresia.
An intussusceptive antireflux valve was created in the Roux-en-Y loop at the same time as the hepatic portojejunostomy (Kasai procedure) for the purpose of preventing ascending cholangitis in 14 new cases of biliary atresia and in 6 long-term survivors of the Kasai operation after episodes of ascending cholangitis. Ascending cholangitis did not develop in any of the 13 new patients who showed bile outflow following a modified Kasai procedure with antireflux valve nor in 5 of 6 patients who had secondary valve implementation. Postmortem examination of a patient with a valve who died 2 years 3 months after surgery showed that the structure of the valve was intact and that the valve still was quite effective as an antireflux mechanism.
Saeki
M
M
Department of Surgery, National Children's Hospital, Tokyo, Japan.
Nakano
M
M
Hagane
K
K
Shimizu
K
K
D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D001655:Bile Reflux / Q000517:prevention & control*; D001656:Biliary Atresia / Q000601:surgery*; D002761:Cholangitis / Q000517:prevention & control*; D006801:Humans; D007443:Intussusception; D007582:Jejunostomy / Q000379:methods*; D007583:Jejunum / Q000098:blood supply; D008638:Mesenteric Arteries / Q000601:surgery; D008642:Mesenteric Veins / Q000601:surgery; D011171:Portoenterostomy, Hepatic / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D013536:Suture Techniques