Effects of Hepatic Periarterial Neurectomy(HPN) on the
Treatment of Biliary Atresia
Takuji Todani and Yasuhiro Watanabe
J Pediatr Surg 17: 158-162, 1982
Thirty one patients with biliary atresia have undergone
Kasai's operation in our clinic during the past 10yr. Three of the patients
died from postoperative complications. Of 12 patients who underwent Kasai's
operation only five (41 .7%) showed good excretion of bile. Two of them.
16.7%. have survived without jaundice for more than 8 yr. Of 16 patients
who underwent hepatic periarterial neurectomy (HPN) combined with hepatic
portoduodenostomy. 11 (68.8%) showed good bile excretion. Seven of them.
43.8%. are alive and well for periods between 6 mo and 5 yr 6 mo postoperatively.
Although improvement in the technique for boring the porta hepatis may have
contributed to these good results. we think that the addition of hepatic
periarterial neurectomy to Kasai's operation gives even better results.
According to our experimental studies. hepatic periarterial neurectomy resulted
in increased bile flow in the early postoperative period and thus seemed
to be of value in preventing postoperative ascending cholangitis.
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