Changes of hepatic volume after successful Kasai operation
Yasuhiro Watanabe, Takuji Todani, Akira Toki, Takuo Noda, Yasuhisa Sato,
Kaoru Ogura, Mikiko Yoshikawa, Sae Yamamoto, Zhong-Qiu Wang
Tohoku J Exp Med 181, 185-191, 1997
The number of long term survivors who have undergone Kasai
operation for biliary atresia is increasing, but some have a hepatic dysfunction
likely to require liver transplantation in the near future. Hepatic volume
possibly reflects whole liver function, and our objective was to assess
the changes of hepatic volume after Kasai operation. Ten patients were studied.
Ages ranged from 3 to 27 years. They underwent Kasai operation at ages ranging
from 50 to 80 days. Liver areas (cm2) on CT images were measured with an
image processing and analysis program (NIH Image 1.57). Hepatic volume (cm3)
was calculated by summing up the areas of each image and multiplying by
slice thickness (cm). After Kasai operation, the size of the liver increased
to 1.7-1.9 times the standard volume, and then reduced to normal size around
5 years of age. In the teens, hepatic volume decreased below the standard
volume. Segmental hypertrophy accompanying atrophy of other hepatic segments
was observed in 9 out of 10 patients; right lobe hypertrophy: 6, medial
segment: 2, and lateral segment: 1. Therefore, progressive hepatic atrophy
begins in the teens, but is compensated for by segmental hypertrophy.
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