Early surgical outcomes and pathological scoring values of older infants (≥ 90 d old) with biliary atresia

Abstract Purpose This study aimed to analyze the impact of age at Kasai operation on the short-term outcome of type III biliary atresia (BA) and to discuss if pathological scoring can be the prediction of effect in the Kasai procedure for the older (≥ 90 days) infant. Methods During the period 2004...

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Bibliographic Details
Published in:Journal of pediatric surgery 2012-12, Vol.47 (12), p.2184-2188
Main Authors: Chen, Gong, Zheng, Shan, Sun, Song, Xiao, Xianmin, Ma, Yangyang, Shen, Wenjun, Chen, Lian, Song, Zai
Format: Article
Language:English
Subjects:
Age
Age Factors
Anastomosis, Surgical - methods
Biliary atresia
Biliary Atresia - mortality
Biliary Atresia - pathology
Biliary Atresia - surgery
Child, Preschool
Cohort Studies
Female
Follow-Up Studies
Humans
Infant
Jaundice, Obstructive - diagnosis
Jaundice, Obstructive - etiology
Jejunostomy - methods
Laparoscopy - methods
Laparoscopy - mortality
Liver - surgery
Male
Pathology
Pediatrics
Postoperative Complications - mortality
Postoperative Complications - physiopathology
Prognosis
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sex Factors
Surgery
Treatment Outcome
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Summary:Abstract Purpose This study aimed to analyze the impact of age at Kasai operation on the short-term outcome of type III biliary atresia (BA) and to discuss if pathological scoring can be the prediction of effect in the Kasai procedure for the older (≥ 90 days) infant. Methods During the period 2004 through 2010, 452 infants with type III BA were reviewed. The relationship between ages at Kasai operation and jaundice clearance rates and two year native liver survival rates were assessed, retrospectively. Pathological slides were analyzed with a histological scoring system. Results All of the patients were divided into 3 groups according to their ages at operation (group A: aged 60 days or less (n = 146), group B: age between 60 and 90 days (n = 222) , and group C: age on or over 90 days (n = 84)). The worst outcome of clearance of jaundice was found in group A but not in group C 2 weeks after the operation (P < 0.05). Jaundice clearance rates showed no difference among the three groups either at 3-months or 6-months after operation. Moreover, in group C patients, the pathological scores showed no difference between the jaundice clearance group and jaundice persistence group 6 months after surgery. In group C, two year survival rate of patients with native livers was 36.1%. Conclusion Some patients over 90 days of age at surgery can still benefit from a Kasai procedure. The pathological scoring system does not play a role in predicting jaundice clearance in patients over 90 days of age at surgery.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2012.09.002