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Short-Term Outcome of Infants with Biliary Artesia Following Kasai Portoenterostomy
Nourhan Medhat Elhadary1, Engy Adel Mogahed2, Nevian Nabil1
1Department of Pediatrics, Cairo University, Cairo, Egypt.
Insights
Kasai portoenterostomy (KPE) offers a short-term jaundice clearance in about one-third of infants with biliary atresia (BA). Early KPE in infants is crucial for improving outcomes in BA treatment.
Area of Science:
- Pediatric Hepatology
- Surgical Gastroenterology
- Neonatal Surgery
Background:
- Biliary atresia (BA) is a severe neonatal cholestatic liver disease.
- Kasai portoenterostomy (KPE) is the primary surgical procedure for BA.
- Assessing KPE's short-term efficacy and prognostic factors is vital for patient management.
Purpose of the Study:
- To evaluate the short-term outcomes of Kasai portoenterostomy (KPE) in infants diagnosed with biliary atresia (BA).
- To identify key prognostic factors influencing the success of KPE in this patient population.
Main Methods:
- A cohort of 127 infants with BA was studied over 10 years.
- Patients underwent KPE and were followed for 6 months post-surgery.
- Successful KPE was defined by jaundice clearance at 6 months.
Main Results:
- Jaundice clearance was achieved in 31.5% of patients at 6 months post-KPE.
- Younger age at the time of KPE was significantly associated with successful outcomes (P=0.03).
- Steroid therapy did not demonstrate a significant improvement in jaundice clearance rates.
Conclusions:
- Kasai portoenterostomy (KPE) demonstrates a 6-month successful outcome in approximately one-third of infants with biliary atresia (BA).
- Performing KPE at a younger age is a critical prognostic factor for achieving jaundice clearance.
- Postoperative steroid therapy did not improve the success rate of KPE.
Objectives:
To assess the short-term outcome of Kasai portoenterostomy (KPE) in infants with biliary atresia (BA) and to identify the prognostic factors for successful KPE.
Methods:
The study included 127 infants with BA who presented to the Pediatric Hepatology Unit, Cairo University over a period of 10 y. All patients were followed up for 6-mo post-KPE. Data retrieved from the patients' files included: history, clinical examination and investigations done at the time of presentation and after 6 mo of KPE. A successful outcome was defined as jaundice clearance after 6 mo of KPE.
Results:
Age at KPE ranged from 30-180 d. Marked fibrosis was present more frequently among older patients. Eighty-seven patients (67%) had yellow-colored stools immediately after KPE. Jaundice clearance 6 mo after KPE was achieved in 40 patients (31.5%). Lower age at time of KPE was significantly associated with successful KPE (P = 0.03). Steroid therapy post-KPE did not show improvement in jaundice clearance.
Conclusions:
KPE had a 6-mo short term successful outcome in one-third of patients with BA. Younger age at KPE is an important prognostic factor to increase the rate of jaundice clearance. Steroids therapy failed to achieve a favorable outcome.
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