Studies on recovery of liver function of operated biliary atresia

Serial liver function studies were analyzed in 42 biliary atresia patients who had undergone portoenterostomy. Values for serum bilirubin, ZTT, TTT, and gamma globulin returned to normal levels three months after operation in patients with good bile excretion. These tests remained abnormal in those with poor bile output. Alkaline phosphatase and serum transaminase values remained high during the early postoperative period, requiring a much longer duration to return to normal. The biological activity of sulfobenzyl penicillin (SBPC) in the serum and bile was determined by serial broth dilution in 15 children with biliary atresia. Eleven patients were studied 10 days to 2 weeks after an apparent successful portoenterosotomy while four others were clinically well and anicteric three to four years postoperatively. The biliary concentration of SBPC was very low despite good bile output during the early postoperative period. The SBPC levels increased three time during the remote postoperative period. The bile concentration of SBPC is lower than normal, however, and it seems that the ability of the liver to excrete this material may never reach normal levels despite apparent good clinical hepatic function.