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Successful Treatment of Congenital Atresia of the Extrahepatic Bile DuctsA Case Report of Treatment by Hepatotomy and Fistula Formation
ARNOLD M. SELIGMAN, M.D.;
STANLEY LEVIN, M.B.B.Ch.
AMA Arch Surg. 1960;80(3):473-481.
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As infants born with congenital atresia of the extrahepatic biliary tract usually die within months to a few years after birth, any surgical approach which offers hope of a cure or alleviation of symptoms warrants thorough investigation. The remarkable course of one such infant who had been explored for jaundice at the age of 3 months is the reason for this report. At age 11 months he was found to have an intraperitoneal biliary cyst which had been tapped at regular intervals for relief of what was considered to be ascites. This relieved his jaundice and probably spared his liver from more extensive biliary cirrhosis. The cyst was marsupialized. At age 14 months a hepatotomy and Roux-en-Y hepatojejunostomy were performed. He developed an external biliary fistula which later communicated with the Y-limb of the jejunostomy and was later converted to an internal fistula merely by clamping the drainage tube. The
. . . [Full Text PDF of this Article]
Author Affiliations
Baltimore
From the Departments of Surgery and Pediatrics, Sinai Hospital of Baltimore, Inc., and The Johns Hopkins University School of Medicine. Present address of Dr. Levin: Department of Pediatrics, Kaplan Hospital, Rehovoth, Israel.
Footnotes
Submitted for publication Aug. 19, 1959.
Study of this patient was supported in part by research grants (A-494, and CY-2478) from the National Institutes of Health, U.S. Department of Health, Education, and Welfare, Bethesda, Md.
The pathological reports are from the Departments of Pathology, The Johns Hopkins Hospital, and the Sinai Hospital of Baltimore, Inc., and cholangiography was by the Department of Radiology, Sinai Hospital of Baltimore, Inc.
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