The extended Kasai portoenterostomy for biliary atresia: A preliminary report
Aims: In 1955, Professor Morio Kasai first performed a hepatic portoenterostomy. Since then, the procedure has changed the lives of children with biliary atresia (BA). We report our initial experience in performing "extended" Kasai portoenterostomy (KPE), a modification of the original pro...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Journal of Indian Association of Pediatric Surgeons |
| Subjects: | |
| Online Access: | http://www.jiaps.com/article.asp?issn=0971-9261;year=2016;volume=21;issue=2;spage=66;epage=71;aulast=Ramachandran |
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| author | Priya Ramachandran Mohamed Safwan Sankaranarayanan Srinivas Naresh Shanmugam Mukul Vij Mohamed Rela |
| author_facet | Priya Ramachandran Mohamed Safwan Sankaranarayanan Srinivas Naresh Shanmugam Mukul Vij Mohamed Rela |
| author_sort | Priya Ramachandran |
| collection | DOAJ |
| description | Aims: In 1955, Professor Morio Kasai first performed a hepatic portoenterostomy. Since then, the procedure has changed the lives of children with biliary atresia (BA). We report our initial experience in performing "extended" Kasai portoenterostomy (KPE), a modification of the original procedure. Materials and Methods: Since 2013, we have used the technique of "extended KPE" and prospectively recorded data on all children undergoing this operation. Data on demographics, clinical features, liver function tests, and perioperative cholangiogram findings were collected. Outcome of KPE was measured by Jaundice Disappearance Rate (JDR) and Native Liver Survival Rate (NLSR). We present our preliminary results from a 30-month period (February 2013 to May 2015). Results: Thirty-one children underwent KPE during this period (19 males) and only 1 child had biliary atresia splenic malformation (BASM). The mean age at KPE was 73 24 days. Five (16.1%) children were more than 90 days old at the time of KPE. Fourteen children cleared jaundice (JDR 45.2%). Eleven (35.5%) children developed episodes of cholangitis, of whom 8 had early cholangitis (within 3 months of the operation). The proportion of children who survived with their own liver 6 months after KPE (NLSR) was 84.2%. Of those children older than 90 days, 2 cleared jaundice and have survived with their native livers for more than 16 months. Conclusion: In our preliminary report of 31 children, we conclude that the extended KPE leads to increased jaundice clearance and improved NLSR in children with BA. |
| first_indexed | 2024-12-23T02:10:50Z |
| format | Article |
| id | doaj.art-25d249ab1e5e49fa9ff1f287df527db0 |
| institution | Directory Open Access Journal |
| issn | 0971-9261 1998-3891 |
| language | English |
| last_indexed | 2024-12-23T02:10:50Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Indian Association of Pediatric Surgeons |
| spelling | doaj.art-25d249ab1e5e49fa9ff1f287df527db02022-12-21T18:03:46ZengWolters Kluwer Medknow PublicationsJournal of Indian Association of Pediatric Surgeons0971-92611998-38912016-01-01212667110.4103/0971-9261.176941The extended Kasai portoenterostomy for biliary atresia: A preliminary reportPriya RamachandranMohamed SafwanSankaranarayanan SrinivasNaresh ShanmugamMukul VijMohamed RelaAims: In 1955, Professor Morio Kasai first performed a hepatic portoenterostomy. Since then, the procedure has changed the lives of children with biliary atresia (BA). We report our initial experience in performing "extended" Kasai portoenterostomy (KPE), a modification of the original procedure. Materials and Methods: Since 2013, we have used the technique of "extended KPE" and prospectively recorded data on all children undergoing this operation. Data on demographics, clinical features, liver function tests, and perioperative cholangiogram findings were collected. Outcome of KPE was measured by Jaundice Disappearance Rate (JDR) and Native Liver Survival Rate (NLSR). We present our preliminary results from a 30-month period (February 2013 to May 2015). Results: Thirty-one children underwent KPE during this period (19 males) and only 1 child had biliary atresia splenic malformation (BASM). The mean age at KPE was 73 24 days. Five (16.1%) children were more than 90 days old at the time of KPE. Fourteen children cleared jaundice (JDR 45.2%). Eleven (35.5%) children developed episodes of cholangitis, of whom 8 had early cholangitis (within 3 months of the operation). The proportion of children who survived with their own liver 6 months after KPE (NLSR) was 84.2%. Of those children older than 90 days, 2 cleared jaundice and have survived with their native livers for more than 16 months. Conclusion: In our preliminary report of 31 children, we conclude that the extended KPE leads to increased jaundice clearance and improved NLSR in children with BA.http://www.jiaps.com/article.asp?issn=0971-9261;year=2016;volume=21;issue=2;spage=66;epage=71;aulast=RamachandranBiliary atresia (BA)jaundice clearanceKasai portoenterostomy (KPE)native liver survival |
| spellingShingle | Priya Ramachandran Mohamed Safwan Sankaranarayanan Srinivas Naresh Shanmugam Mukul Vij Mohamed Rela The extended Kasai portoenterostomy for biliary atresia: A preliminary report Journal of Indian Association of Pediatric Surgeons Biliary atresia (BA) jaundice clearance Kasai portoenterostomy (KPE) native liver survival |
| title | The extended Kasai portoenterostomy for biliary atresia: A preliminary report |
| title_full | The extended Kasai portoenterostomy for biliary atresia: A preliminary report |
| title_fullStr | The extended Kasai portoenterostomy for biliary atresia: A preliminary report |
| title_full_unstemmed | The extended Kasai portoenterostomy for biliary atresia: A preliminary report |
| title_short | The extended Kasai portoenterostomy for biliary atresia: A preliminary report |
| title_sort | extended kasai portoenterostomy for biliary atresia a preliminary report |
| topic | Biliary atresia (BA) jaundice clearance Kasai portoenterostomy (KPE) native liver survival |
| url | http://www.jiaps.com/article.asp?issn=0971-9261;year=2016;volume=21;issue=2;spage=66;epage=71;aulast=Ramachandran |
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