J.Jpn. Surg. Soc.. 80(11): 1304-1308, 1979

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Report on the annual meeting

ETIOPATHOLOGIC AND THERAPEUTIC ASPECTS OF OBSTRUCTIVE JAUNDICE IN CHILDHOOD

In the treatment of noncorrectable type of biliary atresia, successful bile drainage had been not achived until the Kasai's portoenterostomy was widely accepted in Japan. Today, successful bile drainage is thought to be the first step toward cure of the disease. Various complications such as cholangitis, liver cirrhosis, portal hypertention, or hepatic failure will influence the ultimate prognosis. These are continued problems in the treatment of biliary atresia.
In the aspect of choledochal dilatation, Alonso-Lej reported a classification of three types of choledochal cyst in 1959. Since then, presence of the dilatation of intrahepatic biliary ducts has been recongized using operative cholangiography by many authors in Japan. Today, concomitant dilatation of intra-and extrahepatic biliary system has been evaluated and also, anomalous junction on the choledochus and pancreatic duct was found in many cases of choledochal dilatation.
Surgical treatment of the choledochal dilatation was accomplished in 1964 in Japan and complete excision of the cyst proved to be a radical operation to prevent recurrence of jaundice and occurrence of carcinoma in the cyst.
Portal hypertention in the childhood is a major problem in pediatric surgery to prevent variceous bleeding in the course of post-hepatic portoenterostomy and idiopathic orgine.

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