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

  • Tatsuya Suzuki
  • Takashi Hashimoto
  • Satoshi Kondo
  • Yoko Sato
  • Mohamed Hamed Hussein
Original Article



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.


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).


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


Biliary atresia Post-hepatic portoenterostomy Steroid therapy Outcomes 


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Tatsuya Suzuki
    • 1
  • Takashi Hashimoto
    • 2
  • Satoshi Kondo
    • 1
  • Yoko Sato
    • 1
  • Mohamed Hamed Hussein
    • 3
  1. 1.Division of Pediatric Surgery and Transplant SurgeryNagoya City University HospitalNagoyaJapan
  2. 2.Department of Pediatric SurgeryFujita Health UniversityToyoakeJapan
  3. 3.Department of PediatricsNagoya City University Graduate School of Medical SciencesNagoyaJapan

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