J.Jpn. Surg. Soc.. 81(9): 929-933, 1980
Report on the annual meeting
CONGENITAL BILIARY TRACT DILATATION IN CHILDHOOD: SURGERY AND A LONG-TERM FOLLOW-UP STUDY
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The Second Department of Surgery, Kagoshima University School of Mdiciene Eitoku Arima, Yoichiro Kojima, Nobuyuki Tajima, Mutsuaki Ikawa, Hachinen Akita |
1. Etiological factors were analysed as follows: (1) Anomalous junction of the pancreatico-biliary ductal system (AJPBDS) (over 40%), (2) Congenital biliary atresia, extrahepatic (17%), Congenital duodenal atresia or stenosis & anular pancreas (6%), (3) Congenital membraneous stricture of the bile duct (3%), and (4) Others including Caroli's disease (2%). Different surgical procedures should be indicated for each type, and majority of the patients of this disorder should be operated in childhood because many complications such as liver cirrhosis, cholangitis, pancreatitis, choledochal rupture, formation of gallstone or pancreatic stone, arising biliary cancer may occur.
2. The prefered operation for biliary tract dilatation with AJPBDS is considered to be Rouxen-Y limb hepaticojejunostomy with primary excision of the choledochal cyst in order to prevent reflux of pancreatic juice flow into the choledochus, postoperative gall stone formation or cancer from arising in the remaining choledochal cyst.
3. As an early diagnosis of this disease with AJPBDS, episodes of colicky abdominal pain without other disease, an extremely high serum amylase level during the attack of the pain and existence of the biliary tract dilatation or AJPBDS in DIC or ERCP are most useful signs.
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