Outcome of Biliary Atresia After Kasai's Portoenterostomy: A 15-year Experience
Rajeev Redkar1, Parag J Karkera, Vinod Raj
1Department of Pediatric Surgery, Lilavati Hospital and Research Centre; and Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children, Parel; Mumbai, India. Correspondence to: Dr Rajeev Redkar, 14, Buildarch Terrace, 1st Floor, Sitladevi Temple Road, Mahim, Mumbai 400 016, India. rajeev.redkar@gmail.com.
Background:
To study the outcome of Biliary atresia after Kasai's portoenterostomy and clinical and biochemical factors affecting the outcome.
Methods:
Medical record review of patients of biliary atresia operated from January 2000 to December 2014. The following data were collected and analyzed - sex, age at surgery, liver function tests, associated congenital anomalies, and clearance of jaundice (at 3 months). Final outcome was classified as alive, dead, or jaundice-free at last follow-up (minimum 1 year).
Results:
121 patients (61.9% males) were included; 32 (26.5%) were lost to follow-up at 1 year. At last follow-up, out of the 89, 42 (47.2%) were alive, 29 (32.6%) were jaundice-free, and 47 (52.8%) had died. The native liver survival rate at last follow up was 43.8%. 42 (47.2%) patients had complete clearance of jaundice at 3 months post-procedure. Jaundice-clearance rate was significantly high in patients alive (83.3% vs 16.7%, P<0.001)) as compared to those who died later.
Conclusion:
Jaundice clearance at 3 months post surgery is a good early indicator of long term success.
