Better prognostic factor for operation of biliary duct obstruction in newborn are –
Correct Answer: Size of ductule > 200 micron
Description: Answer (b) Size of ductule > 200 micron Surgical treatment of biliary atresia Pooenterostomy or Kasai's operation is the surgery of choice. The purpose of this procedure is to facilitate the flow of bile into the intestine. It is based on the observation that the fibrous tissue at the pa hepatitis invests microscopically patent biliary ductules that in turn communicates with the intrahepatic ductal system. Transecting this fibrous tissue, opens these channels and establishes bile flow into a surgically constructed intestinal conduit, using a Roux-en-Y limb of jejunum. Liver transplantation is done in those, who fail to respond to Pooenterostomy. About prognostic factors for successful outcome of the Kasai operation, we have consulted many books including books on Pediatric Surgery. The maximum information we could get was from CSDT, Maingot's and Schwaz. The prognostic factors are: a) Age of operation - a better prognosis is achieved with age less than 60 days (8 weeks given in 8th edition of Schwaz). b) Absence of cirrhosis - checked by bridging liver fibrosis on biopsy. c) Diameter of bile ductules at the poal plate - ductules greater than 150 gm in diameter are associated with good chances of bile drainage (- Maingot 10/e, p 2123) d) Establishment of adequate bile flow e) Cholangitic episodes - postoperative cholangitic episodes are associated with bad prognosis.
Category:
Surgery
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