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December 1953

CONGENITAL ATRESIA OF THE BILIARY SYSTEM: Delayed Development of Correctability

Author Affiliations

From the Jewish Sanitarium and Hospital for Chronic Diseases, Brooklyn, and St. Luke's Hospital, New York.

AMA Am J Dis Child. 1953;86(6):780-787. doi:10.1001/archpedi.1953.02050080795010

THE EARLIEST report of atresia of the biliary system in newborn children offered no suggestion of treatment and relegated this condition to the status of a congenital anomaly inevitably terminating in death.1 Twenty-four years later, however, Holmes, after careful study of the pathologic material, suggested that in some instances surgical intervention might have established a successful connection between the liver and the intestinal tract.2 This opinion was brilliantly confirmed by Ladd3 and later by Donovan,4 so that early operation is now generally accepted as the proper treatment.

However, these authors and others have reported a substantial proportion of cases in patients in whom exploration reveals a condition of the biliary system deemed to be uncorrectable. Moore, for example, recently reported a total of 135 cases, including 31 of his own.5 In 77% of these cases the biliary system was absent or had not passed the

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