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 language | English (US) |
|---|---|
| Pages (from-to) | 1005-1007 |
| Number of pages | 3 |
| Journal | Journal of Pediatric Surgery |
| Volume | 38 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2003 |
| Externally published | Yes |
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Keywords
- Appendix
- Biliary atresia
- Kasai portoenterostomy
ASJC Scopus subject areas
- Surgery
Cite this
Comparison of drainage techniques for biliary atresia. / Tsao, KuoJen; Rosenthal, Philip; Dhawan, Kapil; Danzer, Enrico; Sydorak, Roman; Hirose, Shinjiro; Farmer, Diana L; Albanese, Craig T.; Harrison, Michael R.; Lee, Hanmin.
In: Journal of Pediatric Surgery, Vol. 38, No. 7, 01.07.2003, p. 1005-1007.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of drainage techniques for biliary atresia
AU - Tsao, KuoJen
AU - Rosenthal, Philip
AU - Dhawan, Kapil
AU - Danzer, Enrico
AU - Sydorak, Roman
AU - Hirose, Shinjiro
AU - Farmer, Diana L
AU - Albanese, Craig T.
AU - Harrison, Michael R.
AU - Lee, Hanmin
PY - 2003/7/1
Y1 - 2003/7/1
N2 - 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.
AB - 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.
KW - Appendix
KW - Biliary atresia
KW - Kasai portoenterostomy
UR - http://www.scopus.com/inward/record.url?scp=0037999970&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037999970&partnerID=8YFLogxK
U2 - 10.1016/S0022-3468(03)00180-5
DO - 10.1016/S0022-3468(03)00180-5
M3 - Article
C2 - 12861527
AN - SCOPUS:0037999970
VL - 38
SP - 1005
EP - 1007
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 7
ER -