STUDIES ON OPERATIVE PROCEDURES AND POSTOPERATIVE CHOLANGITIS FOR CONGENITAL BILIARY DILATATION-A COMPAPISON ADULT AND JUVENILE CASES-

Clinical cases of congenital biliary dilatation were divided into two groups, namely, adult group comprising of 22 patients over 15 year old and juvenile group comprising of 20 patients under 15 years old. These two groups were compared for operative procedure and frequency of postoperative cholangitis by reconstruction procedures, and the possible mechanism of onset of severe post-operative cholangitis in jejunal interposition was studied. 1) The most common reconstruction surgery was Roux-en-Y method (45%) followed by jejunal interposition (36%) in the adult group, and choledochoduodenostomy (75%) in the juvenile group. 2) Frequency of postoperative cholangitis was 27.2% in the adult or 5% in the juvenile group, the higher frequency of occurrence and more severe cases being noted in the adult group. 3) Two severe adult cases of cholangitis were al !those undergoing jejunal interposition for intrahe-patic biliary dilatation (Totani IVA). It was thought that this procedure might be imconpatible to such adult cases. 4) Scintigraphy of the bile duct and gastrointestinal tract indicated a possible mechanism of the onset of severe cholangitis after indicated a posssible mechanism of the onset of severe cholangitis after jejunal interposition that both retention of intrahepatic ble juice and bile juice in the crus of jejunal interposition might be involved.