[Early complications after hepatic porto-jejunostomy in biliary atresia]

Postoperative complications which developed within three years after hepatic porto-jejunostomy (Kasai's operation) in 126 patients of biliary atresia were analyzed. Ascending cholangitis developed in 47 of 97 bile excreted patients. The excretion of bile ceased in another 18 patients without any symptom of cholangitis. Adhesive ileus, bleeding from the porta hepatis, wound dehiscence, and anastomotic leak developed less frequently. The mortality rate of the patients with these complications, especially with cholangitis or with cessation of the bile excretion, was extremely high; twenty nine (62%) out of 47 patients with cholangitis, and 14(78%) out of 18 patients with cessation of the bile excretion died. On the other hand, the mortality rate in 24 patients with bile excretion but without any postoperative complication was only 8% (2 patients). An intussusception type antireflux valve in the Roux-en-Y loop was effective for preventing cholangitis; cholangitis developed in none of 8 patients with an anti-reflux valve, whereas cholangitis developed in 25(48%) of recent 52 patients without a valve.