Comparison of drainage techniques for biliary atresia

KuoJen Tsao, Philip Rosenthal, Kapil Dhawan, Enrico Danzer, Roman Sydorak, Shinjiro Hirose, Diana L Farmer, Craig T. Albanese, Michael R. Harrison, Hanmin Lee

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Purpose: Traditional Kasai portoenterostomy and porto-appendiceal duodenostomy have been utilized for biliary atresia. Differences in outcome between patients who underwent either Kasai portoenterostomy or porto-appendiceal duodenostomy were compared. Methods:A review of all children who underwent a drainage procedure for biliary atresia from 1986 to 2000 (n = 30) was performed. Age at drainage procedure, subsequent liver transplantation, and outcomes were evaluated. Outcome variables included success rates (total bilirubin < 2.0 mg/dL) and survival rate. Statistical analysis was done with χ2 and Student's t test. Results: Long-term follow-up was available on 28 of 30 patients. Age at biliary drainage was insignificant. Success rates between porto-appendiceal duodenostomy (31%) and Kasai portoenterostomy (82%) were statistically significant. Survival rate for patients who underwent a Kasai portoenterostomy was 10 of 11 patients. Survival rate for patients who underwent porto-appendiceal duodenostomy was 14 of 16 patients. Overall survival rate was comparable between porto-appendiceal duodenostomy (88%) and Kasai portoenterostomy (91%). Conclusions: Although overall survival rate was comparable, patients who underwent porto-appendiceal duodenostomy were less successful in alleviating hyperbilirubinemia compared with Kasai portoenterostomy. This is shown further by the greater incidence of subsequent liver transplantation in infants with prior porto-appendiceal duodenostomy. Although the appendix may serve as an alternative biliary conduit, traditional Kasai portoenterostomy appears to achieve better biliary drainage.

Original languageEnglish (US)
Pages (from-to)1005-1007
Number of pages3
JournalJournal of Pediatric Surgery
Volume38
Issue number7
DOIs
StatePublished - Jul 1 2003
Externally publishedYes

Keywords

  • Appendix
  • Biliary atresia
  • Kasai portoenterostomy

ASJC Scopus subject areas

  • Surgery

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    Tsao, K., Rosenthal, P., Dhawan, K., Danzer, E., Sydorak, R., Hirose, S., Farmer, D. L., Albanese, C. T., Harrison, M. R., & Lee, H. (2003). Comparison of drainage techniques for biliary atresia. Journal of Pediatric Surgery, 38(7), 1005-1007. https://doi.org/10.1016/S0022-3468(03)00180-5