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Predictors of Short-Term Outcome of Kasai Portoenterostomy for Biliary Atresia in Infants: a Single-Center Study

Yassin Noha Adel, El-Tagy Gamal, Abdelhakeem Omar Nagy, Asem Noha, El-Karaksy Hanaa,
소속 상세정보
 ( Yassin Noha Adel ) - Cairo University Department of Pediatrics
 ( El-Tagy Gamal ) - Cairo University Department of Pediatric Surgery
 ( Abdelhakeem Omar Nagy ) - Minia University Department of Pediatric Surgery
 ( Asem Noha ) - Cairo University Department of Community Medicine
 ( El-Karaksy Hanaa ) - Cairo University Department of Pediatrics

Abstract


Purpose: The outcome predictors of Kasai portoenterostomy (KPE) for biliary atresia (BA) are controversial. This study aimed to identify possible short-term outcome predictors of KPE for BA in infants.

Methods: This retrospective study included infants with BA who underwent KPE between January 2015 and December 2017 and were followed up for at least 6 months after surgery at the Pediatric Hepatology Unit, Cairo University Pediatric Hospital, Egypt. The short-term outcome was jaundice clearance within 6 months following surgery. All data were compared between the jaundice free group and those with persistent jaundice to identify the predictors of jaundice clearance.

Results: The study included 75 infants. The mean age at the time of surgery was 82.43±22.77 days (range, 37?150 days), and 28 (37.3%) infants cleared their jaundice within 6 months postoperative. Age at surgery did not significantly affect the outcome (p=0.518). Infants with persistent jaundice had significantly higher pre-operative levels of aspartate aminotransferase (AST) than those who were jaundice free (p=0.041). Receiver operating characteristic curve analysis showed that preoperative AST ≤180 IU/L was predictive of a successful KPE, with sensitivity 74.5% and specificity 60.7%. Infants with bile plugs in liver biopsy had a 6-fold higher risk of persistent jaundice than those without bile plugs (95% confidence interval: 1.59?20.75, p=0.008).

Conclusion: Jaundice clearance after KPE for BA can be predicted using preoperative AST and presence of bile plugs in liver biopsy.

키워드

Biliary atresia; Portoenterostomy, hepatic; Outcome

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