Pediatric Surgery International

, Volume 26, Issue 8, pp 825–830

Evaluating patients’ outcome post-Kasai operation: a 19-year experience with modification of the hepatic portoenterostomy and applying a novel steroid therapy regimen

Authors

    • Division of Pediatric Surgery and Transplant SurgeryNagoya City University Hospital
  • Takashi Hashimoto
    • Department of Pediatric SurgeryFujita Health University
  • Satoshi Kondo
    • Division of Pediatric Surgery and Transplant SurgeryNagoya City University Hospital
  • Yoko Sato
    • Division of Pediatric Surgery and Transplant SurgeryNagoya City University Hospital
  • Mohamed Hamed Hussein
    • Department of PediatricsNagoya City University Graduate School of Medical Sciences
Original Article

DOI: 10.1007/s00383-010-2637-y

Cite this article as:
Suzuki, T., Hashimoto, T., Kondo, S. et al. Pediatr Surg Int (2010) 26: 825. doi:10.1007/s00383-010-2637-y

Abstract

Background

We reported a modification of the hepatic portoenterostomy (HPE) for biliary atresia with favorable results. HPE is associated with a risk of hepatic impairment, so we adopted a novel steroid therapy regimen well suited to our procedure. This paper reports the results of our experience.

Patients and methods

Between 1991 and 2009, 53 patients (18 boys, 35 girls) underwent modified HPE with novel steroid therapy, which consisted of administering hydrocortisone immediately after surgery, followed by intravenous administration of prednisolone. The number of patients who became normal total bilirubin (TB) levels, frequency of early onset cholangitis and other postoperative complications, and outcomes were retrospectively studied.

Results

The TB levels in 43 of the 53 patients became normal. Cholangitis was observed in seven, but all of them recovered. Other postoperative complications were noted in eight, but with no fatal cases. Of the 11 patients who underwent living-donor liver transplantation, 3 died after the transplant. Of the 53 patients, 39 are alive without liver transplantation and 34 have normal TB (range of observation period: 18 years and 9–2 months).

Conclusions

The novel steroid regimen may have contributed to the outcome and appears to be well suited to the modified HPE.

Keywords

Biliary atresiaPost-hepatic portoenterostomySteroid therapyOutcomes

Copyright information

© Springer-Verlag 2010