Predictors of Short-Term Outcome of Kasai Portoenterostomy for Biliary Atresia in Infants: a Single-Center Study
10.5223/pghn.2020.23.3.266
- Author:
Noha Adel YASSIN
1
;
Gamal EL-TAGY
;
Omar Nagy ABDELHAKEEM
;
Noha ASEM
;
Hanaa EL-KARAKSY
Author Information
1. Department of Pediatrics, Cairo University, Cairo, Egypt
- Publication Type:Original Article
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2020;23(3):266-275
- CountryRepublic of Korea
-
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.
