Objectives: Kasai portoenterostomy (KPE) is the primary treatment for biliary atresia (BA) with subsequent liver transplantation in failed cases. The aim of this work was to study the outcome of KPE in children with BA and identify the factors predicting a successful KPE.
Methods: Children diagnosed with BA and undergoing KPE between January 2010 and January 2018 were included in the study. A successful KPE was defined as decrease in bilirubin to less than 2 mg/dL at 6 months after KPE. Factors affecting the outcome (successful KPE and survival with native liver [SNL] at 2 years) were evaluated by logistic regression.
Results: A total of 79 children with post-KPE BA were included. Successful KPE was achieved in 29 (36.7%) of 79 children undergoing KPE. The data for survival with native liver at 2 years were available for 61 children as 9 were lost to follow up before 2 years and another 9 were aged less than 2 years at the time of analysis. Twenty-seven (44.3%) of these 61 survived with their native liver at 2 years. On logistic regression analysis, lower age at KPE, use of postoperative steroids and absence of cholangitis were significant predictors of a successful KPE. A successful KPE at 6 months was the lone independent predictor of SNL at 2 years in these children.
Conclusion: Early age at KPE, use of postoperative steroid and prevention of cholangitis can result in successful KPE. Those with successful KPE are likely to survive with their native liver at 2 years.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728523 | PMC |
| http://dx.doi.org/10.1016/j.jceh.2018.09.008 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Optimizing Post-Kasai Management in Biliary Atresia: Balancing Native Liver Survival and Transplant Timing.
Eur J Pediatr Surg
December 2024
Pediatric Surgery, UKE, Hamburg, Germany.
Background Kasai procedure (KPE) is a palliative intervention in infants with biliary atresia (BA) aiming to restore biliary drainage. While the measure of success in BA is the post-Kasai native liver survival, BA remains the most frequent indication for liver transplantation in children. While a considerable amount of children fail to clear their jaundice following KPE, resulting in early liver failure and transplantation, some children become jaundice-free after "successful" KPE.
View Article and Find Full Text PDFComparison of different Kasai portoenterostomy techniques in the outcomes of biliary atresia: a systematic review and network meta-analysis.
Pediatr Surg Int
November 2024
Department of General Surgery, Tianjin Children's Hospital, Tianjin, 300134, China.
Article Synopsis
- - Biliary atresia (BA) is a serious liver condition that worsens without prompt surgery; the Kasai portoenterostomy (KPE) is a common surgical option to improve bile flow, with varying success rates based on the surgical method used (laparoscopic, robot-assisted, or open).
- - A comprehensive review of existing studies identified no significant differences in the postoperative outcomes of the three surgical techniques, although robot-assisted KPE showed slightly better results compared to open and laparoscopic methods concerning successful clearance of jaundice.
- - The choice of surgical technique should be personalized based on the patient's circumstances and potential costs, emphasizing the importance of effective postoperative care to minimize complications.
Primary antibiotic prophylaxis in biliary atresia did not demonstrate decreased infection rate: Multi-centre retrospective study.
Acta Paediatr
November 2024
Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Aim: This retrospective study aimed to assess the efficacy of prophylactic antibiotics in preventing ascending cholangitis following Kasai portoenterostomy (KPE). Data from 72 patients treated across four tertiary centres in Israel from 2008 to 2018 were analysed.
Methods: Clinical and laboratory data were collected from biliary atresia (BA) diagnosis until liver transplantation (LT) or study completion.
Role of percutaneous transhepatic biliary drainage for managing bile lake formation after Kasai portoenterostomy.
Pediatr Surg Int
October 2024
Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Purpose: Bile lake (BL) formation following Kasai portoenterostomy (KPE) can complicate the prognosis of biliary atresia (BA). Percutaneous transhepatic biliary drainage (PTBD) performed under fluoroscopic/ultrasonographic (US) guidance is discussed for the management of BL.
Methods: A retrospective review of 64 BA patients treated by KPE (open = 31, laparoscopic = 33) at a single center (2004-2023) identified 9 BL cases (9/64; 14.
Human Liver Organoids to Predict the Outcome of Kasai Portoenterostomy.
J Pediatr Surg
February 2025
Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China. Electronic address:
Article Synopsis
- Kasai portoenterostomy (KPE) is the main treatment for biliary atresia (BA), but predicting outcomes is difficult due to unreliable biomarkers.
- Researchers analyzed liver biopsies from BA patients before and after KPE and compared them to control liver samples, focusing on gene expression changes.
- Findings suggest that high hepatocyte expression in KPE organoids may indicate abnormal cholangiocyte development, while a transition towards more cholangiocyte features in surviving patients suggests better biliary recovery.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!