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Technical standardization of Kasai portoenterostomy for biliary atresia
- Source :
- Journal of pediatric surgery. 51(12)
- Publication Year :
- 2016
-
Abstract
- Background The purpose of this study was to assess the clinical outcome of patients treated with the current technique of Kasai procedure compared with that of those treated with previous procedures. Methods We retrospectively assessed the outcomes of 256 patients with biliary atresia who underwent Kasai portoenterostomy at our hospital between 1972 and 2014. Patients were divided into four groups: group 1 (1972–1981, double Roux-en Y, n=91), group 2 (1982–1991, Suruga II, n=80), group 3 (1992–2000, double-valve Roux-en Y, n=46), and group 4 (2001–2014, total removal of the extrahepatic biliary remnants at hepatic capsule and Roux-en Y reconstruction with a spur valve, n=39). Clinical outcomes were compared between the four groups. Results In groups 1, 2, 3, and 4, the rate of jaundice clearance was 65.9%, 77.5%, 63.0%, and 87.2%, respectively; incidence of early cholangitis was 60.4%, 53.8%, 37.0%, and 23.1%, respectively; requirement for redo Kasai surgery was 15.4%, 37.5%, 17.4%, and 5.1%, respectively; 10-year native liver survival rate was 53.8%, 60.1%, 44.1%, and 73.7%, respectively; and 10-year overall survival rate was 55.0%, 72.3%, 86.7%, and 97.3%, respectively. Conclusion The standardized Kasai procedure was associated with favorable outcomes. Long-term outcomes remain to be evaluated. Level of evidence Case–control/treatment study, level III.
- Subjects :
- Male
medicine.medical_specialty
Portoenterostomy, Hepatic
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Japan
Biliary atresia
Biliary Atresia
030225 pediatrics
Internal medicine
Medicine
Humans
Survival rate
Retrospective Studies
Kasai procedure
business.industry
Incidence (epidemiology)
Hepatic capsule
Infant
General Medicine
Jaundice
medicine.disease
Surgery
Survival Rate
Treatment Outcome
Liver
030220 oncology & carcinogenesis
Pediatrics, Perinatology and Child Health
Total removal
Female
Level iii
medicine.symptom
business
Subjects
Details
- ISSN :
- 15315037
- Volume :
- 51
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Journal of pediatric surgery
- Accession number :
- edsair.doi.dedup.....e74dbc54fb9cd5992426b5f9f8ba7c79