The characteristics of patients who failed initial Kasai portoenterostomy and the long-term prognosis of those who underwent redo-Kasai: a retrospective observational study
10.4174/astr.2025.108.2.93
- Author:
Suhyeon HA
1
;
Sujin GANG
;
Jueun PARK
;
Hyunhee KWON
;
Dae Yeon KIM
;
Seong Chul KIM
;
Jung-Man NAMGOONG
Author Information
1. Division of Pediatric Surgery, Asan Medical Center Children’s Hospital, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Annals of Surgical Treatment and Research
2025;108(2):93-97
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:The purpose of this study was to determine the characteristics of patients with failed initial Kasai portoenterostomy (KP) and to compare the long-term prognosis of redo-KP with that of liver transplantation (LT) in these patients.
Methods:The medical records of patients with biliary atresia (BA) who failed initial KP from 2010 to 2021 at a single center were retrospectively analyzed. KP failure was defined as persistent jaundice (total bilirubin concentration, ≥2.0 mg/dL) after KP or the performance of LT.
Results:During the study period, 32 patients experienced initial KP failure, with 10 undergoing redo-KP and 22 undergoing LT. Redo-KP was successful in a minority of patients with failed initial KP, but the complications, particularly cholangitis, were more frequent in the redo-KP group. The long-term prognosis of redo-KP compared to LT showed that while some patients benefited from native liver survival after redo-KP, LT remains the more definitive solution for sustained liver function and survival in patients with BA.
Conclusion:The only factor differing significantly between patients who underwent redo-KP and LT after failed initial KP was complications of cholangitis. Redo-KP was successful in 4 of 10 patients with failed initial KP, suggesting that redo-KP may be a treatment option in patients with BA and failed initial KP.
