Hepatic portoenterostomy may be performed in an infant with biliary atresia. One complication is cholangitis. Recurrent cholangitis may ultimately contribute to failure of the portoenterostomy and necessitate liver transplantation.
Patient selection: hepatic portoenterostomy (hepatoportoenterostomy) for biliary atresia
Risk factors for cholangitis:
(1) NOT good bile drainage (fair or poor)
(2) failure to administer antibiotics appropriately (prophylaxis, other)
(3) abnormal intrahepatic bile ducts
(4) cavities (cystic areas) at the porta hepatis
External diversion is not recommended since it (a) does not reduce the rate of cholangitis and (b) is associated with severe and fatal complications.
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