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http://dx.doi.org/10.5223/pghn.2020.23.3.266

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

Yassin, Noha Adel (Department of Pediatrics, Cairo University)
El-Tagy, Gamal (Department of Pediatric Surgery, Cairo University)
Abdelhakeem, Omar Nagy (Department of Pediatric Surgery, Minia University)
Asem, Noha (Department of Community Medicine, Cairo University)
El-Karaksy, Hanaa (Department of Pediatrics, Cairo University)
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.23, no.3, 2020 , pp. 266-275 More about this Journal
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.
Keywords
Biliary atresia; Portoenterostomy, hepatic; Outcome;
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