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 Citations (Scopus)

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

Fingerprint

Duodenostomy
Biliary Atresia
Drainage
Survival Rate
Liver Transplantation
Hyperbilirubinemia
Bilirubin
Students

Keywords

  • Appendix
  • Biliary atresia
  • Kasai portoenterostomy

ASJC Scopus subject areas

  • Surgery

Cite this

Tsao, K., Rosenthal, P., Dhawan, K., Danzer, E., Sydorak, R., Hirose, S., ... 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

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 journalArticle

Tsao, K, Rosenthal, P, Dhawan, K, Danzer, E, Sydorak, R, Hirose, S, Farmer, DL, Albanese, CT, Harrison, MR & Lee, H 2003, 'Comparison of drainage techniques for biliary atresia', Journal of Pediatric Surgery, vol. 38, no. 7, pp. 1005-1007. https://doi.org/10.1016/S0022-3468(03)00180-5
Tsao, KuoJen ; Rosenthal, Philip ; Dhawan, Kapil ; Danzer, Enrico ; Sydorak, Roman ; Hirose, Shinjiro ; Farmer, Diana L ; Albanese, Craig T. ; Harrison, Michael R. ; Lee, Hanmin. / Comparison of drainage techniques for biliary atresia. In: Journal of Pediatric Surgery. 2003 ; Vol. 38, No. 7. pp. 1005-1007.
@article{96603b82e02148858a7ce11bd333af65,
title = "Comparison of drainage techniques for biliary atresia",
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.",
keywords = "Appendix, Biliary atresia, Kasai portoenterostomy",
author = "KuoJen Tsao and Philip Rosenthal and Kapil Dhawan and Enrico Danzer and Roman Sydorak and Shinjiro Hirose and Farmer, {Diana L} and Albanese, {Craig T.} and Harrison, {Michael R.} and Hanmin Lee",
year = "2003",
month = "7",
day = "1",
doi = "10.1016/S0022-3468(03)00180-5",
language = "English (US)",
volume = "38",
pages = "1005--1007",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "7",

}

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 -