Fat absorption in patients with surgically repaired biliary atresia.

The degree of fat absorption was studied in 4 patients with unrepaired biliary atresia and 11 with repaired biliary atresia (6 with mild jaundice, 5 with no jaundice). The percent absorption was conspicuously reduced in unrepaired patients (mean 30%, range 21 to 39%), moderately reduced in repaired patients with mild jaundice (mean 78%, range 67 to 89%), and completely normal in repaired patients with no jaundice (mean 93%, range 89 to 97%). The excretion pattern of main fecal fatty acids in unrepaired patients was very different from that of normal controls, low in stearic and high in oleic, but very similar to the pattern of fatty acids contained in ingested milk. In repaired patients with mild or no jaundice the pattern was an intermediate one between those of normal controls and unrepaired patients. The effect of medium-chain triglycerides on fat absorption was favorable in repaired patients with mild jaundice, but not in those with no jaundice. There was an inverse correlation between fat absorption and 15 min indocyanine green retention value.