Kasai portoenterostomy for the treatment of biliary atresia: our experience of 112 cases

Abstract

Objective To summarize our experience on Kasai procedure (KP) for the treatment of biliary atresia (BA).Methods From January 2007 to December 2011,126 patients with type ⅢBA underwent KP at this center.After surgery,112 (89.7％) of them was followed up,and their clinical data were retrospectively analyzed to evaluate the outcome.Results The jaundice free was seen in 70 (62.5％) patients.According to the age at surgery,the patients were divided into 4 groups:≤60 d group,60～90 d group,90～120 d group,and ＞120 d group.The jaundice free rates of the 4 groups were statistically different (jaundice free rate 72.0％,80.5％,60.0％,and 19.0％,respectively,P＜0.05).The incidence of cholangitis was 30.4％ (34/112).The incidence of cholangitis in jaundice free patients was significantly lower than that of the patients with persistent jaundice (21.4％versus 45.2％,P＜0.05).The patients with the age at surgery ＞90 d (93.5％),or persistent jaundice (100％),or postoperative cholangitis (50％),had a higher incidence of hepatic fibrosis.The 1-year and 2-year survival rate with native liver was 64.9％ and 61.8％ respectively.Age at surgery,jaundice,severity of cholangitis and persistent hepatic fibrosis,were the predictive factors for outcomes of surgery (P＜0.05).Conclusions The type Ⅲ BA patients who are younger than 90 days at surgery,jaundice free and less incidence cholangitis after surgery have longer survival time with native liver. Key words: Biliary atresia; Anastomosis, surgical; Survival Rate