">
Splenectomy in Biliary Atresia
Patients with Recurrent Jaundice
Following Partial Splenic
Embolization
-
HISAMI
ANDO,
TAKAHIRO
ITO,
TAKAHIKO
SEO,
FUJIO
ITO and
KENITIRO
KANEKO
-
Department of Surgery, Branch
Hospital, University of Nagoya
School of Medicine, Nagoya 461
Splenectomy was performed for three
patients with biliary atresia
because of re-exacerbation of their
jaundice following treatment by
partial splenic embolization (PSE).
The subjects' red blood cell count
and hemoglobin, serum level of
hepatic enzymes (glutamic
oxaloacetic transaminase, glutamic
pyruvic transaminase, g-glutamyl
transpeptidase, alkaline
phosphatase, and lactic
dehydrogenase), and total bilirubin
(TB) were evaluated both before and
after splenectomy in order to
analyze the effects of splenectomy
on these patients. The TB decreased
significantly within 3 months after
splenectomy in all three patients (
13.0+-1.6 mg/lOO ml to 5.4+-0.3 mg/
100 ml, p<0.05). The red blood
cell count and hemoglobin increased
gradually. There was a statistically
significant correlation between the
TB and the red blood cell count,
and/or concentration of hemoglobin.
The hepatic enzymes after
splenectomy were not significantly
different from those before
splenectomy. The change in TB
following splenectomy was
essentially similar to that
following PSE. These results
suggested that the postoperative
improvement in jaundice following
splenectomy may not be due to
improved hepatic function but merely
a reflection of decreased red blood
cell turnover. Splenectomy is a
useful palliative procedure for
jaundice in patients with biliary
atresia for whom PSE is no longer
effective.
Key word(s)---
biliary atresia; splenectomy;
partial splenic embolization;
jaundice; spleen
Tohoku J. Exp. Med., 1997, 181,
167-174
Address for reprints:
Hisami Ando, M.D., Department of
Surgery, Branch Hospital, University
of Nagoya School of Medicine, 1-1-20
Daikohminami, Higashi-ku, Nagoya
461, Japan.
Back to CONTENTS.