A rare case of a successful Kasai operation for biliary atresia in a 9 month old is described. For infants over 6 months of age, there had been no reports of long-term survival after this procedure.
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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.
Cost- effectiveness of a simplified acute malnutrition program: a secondary analysis of the OptiMA randomized clinical trial in the Democratic Republic of the Congo.
Health Policy Plan
November 2024
Yale University School of Public Health, New Haven, CT USA.
Acute malnutrition (AM) causes large loss of life and disability in children in Africa. Researchers are testing innovative approaches to increase efficiency of treatment programs. This paper presents results of a cost-effectiveness analysis of one such program in the Democratic Republic of the Congo (DRC) based on a secondary analysis of a randomized controlled trial Optimizing Treatment for Acute Malnutrition (OptiMA), conducted in DRC in 2018-20.
View Article and Find Full Text PDFExplant pathology in Biliary Atresia post Kasai procedure: a tale of two livers.
Autops Case Rep
October 2024
Sir Ganga Ram Hospital, Pediatric Gastroenterology and Hepatology, New Delhi, India.
Article Synopsis
- - Biliary atresia (BA) is a severe liver condition in infants that causes inflammation and blockage of bile ducts, leading to cirrhosis within two years if untreated.
- - Early diagnosis is crucial, and the best initial treatment is the Kasai procedure, which should be performed within the first two months of life to maximize the chances of success.
- - The outcomes of the Kasai procedure vary, with potential long-term complications requiring liver transplant; pathologists need to differentiate between various liver damage patterns in successful versus failed surgeries for accurate diagnosis.
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