Surgical outcomes of infants undergoing Kasai operation under 60 days with biliary atresia
Song Zai, Zheng Shan, Dong Kuiran, Chen Gong, Sun Song, Chen Xiaoli, Xiao Xianmin
Published 2014-04-15
Cite as Chin J Pediatr Surg, 2014,35(04): 254-258. DOI: 10.3760/cma.j.issn.0253-3006.2014.04.005
Abstract
Objective To analyze the impact of etiologic heterogeneity and operative age on short-term outcomes of biliary atresia (BA) undergoing Kasai operation under 60 days.Methods During the period of 2004-2010,a total of 476 BA infants were reviewed.According to the preoperative examinations,4 groups could be defined clinically as cystic BA,syndromic with associated malformations,cytomegalovirus (CMV)-associated and isolated.Results Among them,158 infants underwent Kasai operation under 60 days.There were cystic (n =19),syndromic with associated malformations (n =36),CMV-associated (n =35) and isolated (n =68).The best outcomes were obtained in infants undergoing Kasai operation between 51 to 60 days (62.1%,46/74) while those operated under 40 days had the worse prognosis (42.8%,12/28).Infants with cystic BA had better outcomes than other three groups (68.4%,P<0.05).Furthermore,this group had favorable prognosis in any operative age.Significant differences existed among the groups of syndromic with malformations (55.9%),CMV-associated BA (57.1%) and isolated BA (52.9%,P>0.05).Syndromic with malformations group,CMVassociated BA group and those with an early operation (<40 days) had worse outcomes than those operated between 41-50 days and 51-60 days(P =0.041<0.05,P =0.029<0.05).However,in isolated group,infants operated under 40 days had the same outcome with those between 41-50 days (50.0 % vs 57.1%,P>0.05),and also had no significance with those from 51-60 days (50.0% vs 54.8%,P>0.05).Conclusions To some extent,operative age has impact on outcome.When Kasai operation is performed under 60 days,infants operated from 51-60 days achieve better outcomes.Clinical etiologic heterogeneity may have prognostic significance.
Key words:
Biliary atresia; Prognosis; Clinical etiologic
Contributor Information
Song Zai
Department of Surgery , Children's Hospital, Fudan University, Shanghai 201102, China
Zheng Shan
Department of Surgery , Children's Hospital, Fudan University, Shanghai 201102, China
Dong Kuiran
Department of Surgery , Children's Hospital, Fudan University, Shanghai 201102, China
Chen Gong
Department of Surgery , Children's Hospital, Fudan University, Shanghai 201102, China
Sun Song
Department of Surgery , Children's Hospital, Fudan University, Shanghai 201102, China
Chen Xiaoli
Department of Surgery , Children's Hospital, Fudan University, Shanghai 201102, China
Xiao Xianmin
Department of Surgery , Children's Hospital, Fudan University, Shanghai 201102, China