TY - JOUR
T1 - Outcome of early hepatic portoenterostomy for biliary atresia
AU - Volpert, D.
AU - White, F.
AU - Finegold, M. J.
AU - Molleston, J.
AU - DeBaun, M.
AU - Perlmutter, D. H.
PY - 2001
Y1 - 2001
N2 - Background: The outcome of the hepatic portoenterostomy (Kasai) procedure for biliary atresia is improved when it is performed before 90 days of age. However, it is not known whether intervention before 30 days is better than intervention between 30 and 90 days. Methods: The authors reviewed the records of all patients seen by the Pediatric Gastroenterology Service at St. Louis Children's Hospital from 1984-1999 to ascertain the outcome of patients who underwent Kasai procedure before or after 30 days of age. Results: Of 92 patients with biliary atresia treated at St. Louis Children's Hospital over 15 years, 9 underwent the Kasai procedure before 30 days of age. Liver transplantation was necessary in 77.8% of these patients at a mean age of 11.0 ± 4.26 months, as compared with 53.4% at 32.14 ± 7.14 months for the remainder of the patients who underwent the procedure after 30 days of age. Conclusions: Although these data suggest that outcomes are worse for patients who undergo the procedure before 30 days of age, they may reflect a difference in the pathogenesis of biliary atresia that brings it to clinical attention earlier and may provide further evidence that biliary atresia is a phenotype for a number of distinct underlying disease processes.
AB - Background: The outcome of the hepatic portoenterostomy (Kasai) procedure for biliary atresia is improved when it is performed before 90 days of age. However, it is not known whether intervention before 30 days is better than intervention between 30 and 90 days. Methods: The authors reviewed the records of all patients seen by the Pediatric Gastroenterology Service at St. Louis Children's Hospital from 1984-1999 to ascertain the outcome of patients who underwent Kasai procedure before or after 30 days of age. Results: Of 92 patients with biliary atresia treated at St. Louis Children's Hospital over 15 years, 9 underwent the Kasai procedure before 30 days of age. Liver transplantation was necessary in 77.8% of these patients at a mean age of 11.0 ± 4.26 months, as compared with 53.4% at 32.14 ± 7.14 months for the remainder of the patients who underwent the procedure after 30 days of age. Conclusions: Although these data suggest that outcomes are worse for patients who undergo the procedure before 30 days of age, they may reflect a difference in the pathogenesis of biliary atresia that brings it to clinical attention earlier and may provide further evidence that biliary atresia is a phenotype for a number of distinct underlying disease processes.
KW - Biliary atresia
KW - Ductal plate malformation
KW - Hepatic portoenterostomy
KW - Neonatal jaundice
UR - http://www.scopus.com/inward/record.url?scp=0035034871&partnerID=8YFLogxK
U2 - 10.1097/00005176-200103000-00006
DO - 10.1097/00005176-200103000-00006
M3 - Article
C2 - 11345173
AN - SCOPUS:0035034871
SN - 0277-2116
VL - 32
SP - 265
EP - 269
JO - Journal of pediatric gastroenterology and nutrition
JF - Journal of pediatric gastroenterology and nutrition
IS - 3
ER -