[A clinical analysis of internal or external diversion in biliary atresia]

Cholangitis has been the most common postoperative complication of Kasai's operation for biliary atresia. A host of ingenious surgical procedures have been used to prevent this complication, some including exteriorization of the bilioenteric conduit. The purpose of this report was to investigate the role of the derivation on the incidence of cholangitis, liver function and the survival of patients with biliary atresia treated with Kasai's operation. We have analyzed the clinical data of thirty-six patients with biliary atresia treated with Kasai's portoenterostomy during a seven year period (1987-1993). The patients were divided into two groups: Group I, patients treated with portoenterostomy and exteriorization of the bilioenteric conduit (n = 18) and Group II, patients treated with portoenterostomy without enterostomy. Our results suggest that the use of the exteriorization of the bilioenteric conduit was not shown to be effective in the prevention of episodes of cholangitis. The survival for both groups was not statistically significant and there was no increase in morbidity after the postoperative period or during the liver transplant.