Studies in neonatal hepatitis and biliary atresia. 3. Progression and regression of cirrhosis in biliary atresia.

Abstract

SUCCESSFUL repair of atresia of the bile ducts continues to be a rare occurrence. 1,2 On the other hand, abdominal surgery increases the mortality and morbidity of neonatal hepatitis, and appears to be an adverse factor in long-term prognosis. 3 The desire to restore function early in the course of biliary obstruction and the difficulty in distinguishing biliary atresia from neonatal hepatitis have led to exploratory laparotomy in undiagnosed cases of obstructive jaundice during the earliest months of life. In this report, the effects of persistent biliary obstruction on the development of hepatic fibrosis and liver function are investigated, and the possibility of restoration of liver structure and function following successful surgical repair of atretic ducts is considered. Materials and Methods Biopsy and autopsy materials from patients with biliary atresia admitted during a ten-year period (June 1954 to July 1964) to the Hospital for Sick Children, Toronto, and the Children's