We studied the choleretic effect of
Prostaglandin E2 (
PGE2) in patients with
biliary atresia. In the last four years
PGE2 was used in ten cases with
extrahepatic biliary atresia. All of them were treated by Kasai technique and temporary exteriorization of the bilioenteric conduit, permitting analyses of the postoperative bile flow. Mean age al operation was 50 days (range 30-70 days). The histology studies of liver and porta hepatis showed severe hepatic
fibrosis in three patients, moderate in seven, bile ducts less than 100 mu in five and more than 100 mu in another five. The mean postoperative bile flow was 15 c.c./day (range 0-30 c.c.). We used
PGE2 during postoperative period because the bile excretion was partial or total stopped (
PGE2 0.125 mgr./kgr./day). In six cases the bile flow increase until 90 c.c./day (range 40-160 c.c./day) and four patients no response. Eight patients are alive, four without
jaundice with normal hepatic function (serum
bilirubin 1.04 mgr./dl) and four are waiting for
liver transplantation. Two have died 7 and 30 months after
Kasai procedure. The long-term follow-up was between 6 to 53 months. In conclusion the
PGE2 has choleretic action in
biliary atresia and could be a coadjuvant treatment to improve the bile flow.