title: Prognostic implications of bile lakes after surgery for biliary atresia.
abstract: OBJECTIVE
  The aim of the study was to establish the natural history of bile lakes (BLs) in patients with postportoenterostomy biliary atresia (BA) and assess their prognostic implications, in particular, if they are a risk factor for cholangitis.
  
  
  METHODS
  One hundred twenty-one postsurgical BA patients were divided into 2 groups as follows: period 1, or preliver transplantation era group (n = 56), and period 2, or liver transplantation era group (n = 65). Presence of BL and outcome were examined in relation to the incidence of cholangitis.
  
  
  RESULTS
  In period 1, there were more multiple BLs (MBLs) in nonsurvivors than survivors. Non-BL survivors had significantly lower mean total number of episodes of cholangitis than MBL survivors (P < .01). In period 2, 58 survived (native liver in 35; transplanted liver in 23). Bile lakes were present in 9/58 (16%) survivors (single in five, multiple BLs in four), and 1/7 (14%) nonsurvivors had MBLs. Mean total number of episodes of cholangitis in the 4 MBL survivors and the 49 non-BL survivors were not significantly different.
  
  
  CONCLUSIONS
  Our results suggest that presence of BL is a risk factor for cholangitis in the long-term but not in the short-term.
authors.affiliation: Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Inoue
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kato
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tamura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Satoko
authors.initials: S
authors.lastname: Ichikawa
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Lane
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Yamataka
mesh_terms: D001646:Bile / Q000000981:diagnostic imaging*; D001652:Bile Ducts / Q000000981:diagnostic imaging* / Q000473:pathology; D001656:Biliary Atresia / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D002761:Cholangitis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D008297:Male; D011171:Portoenterostomy, Hepatic; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014463:Ultrasonography