Prognosis of extrahepatic bile-duct atresia after hepatoportoenterostomy.
Clinical and histologic findings from 206 patients operated upon for extrahepatic biliary atresia (EHBA) are analyzed in order to define the prognosis of patients with EHBA. The prospective study took into consideration both initial fibrosis of the liver and the morphology of the porta hepatis (PH) at surgery. Kaplan-Meier survival estimates and statistical calculations demonstrated a relationship between long-term survival and histologic findings in the liver and porta hepatis. The efficacy of HPE is significantly influenced by the morphology of the PH and to a lesser extent by the initial liver fibrosis. Surgery should thus achieve pattern 1 morphology of the PH, but this is problematic because of the close relationship of the vascular and biliary structures in its two lateral zones.
Schweizer
P
P
Department of Pediatric Surgery, University of Tübingen Children's Hospital, Germany.
Schweizer
M
M
Schellinger
K
K
Kirschner
H J
HJ
Schittenhelm
C
C
D001656:Biliary Atresia / Q000097:blood / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001663:Bilirubin / Q000097:blood; D002648:Child; D002761:Cholangitis / Q000209:etiology; D004932:Esophageal and Gastric Varices / Q000209:etiology; D006801:Humans; D006971:Hypersplenism / Q000209:etiology; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology; D011171:Portoenterostomy, Hepatic / Q000009:adverse effects / Q000379:methods*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012720:Severity of Illness Index; D013163:Splenomegaly / Q000209:etiology; D016019:Survival Analysis; D016896:Treatment Outcome
D001663:Bilirubin