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The short-term outcome of modified laparoscopic Kasai portoenterostomy for biliary atresia

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Abstract

Objectives

Laparoscopic Kasai portoenterostomy (LKPE) has been shown to be a safe and feasible procedure in patients with biliary atresia (BA). The purpose of this study was to investigate the efficacy of modified LKPE (MLKPE) in the treatment of BA.

Methods

Data of 58 BA patients undertaken MLPKE from July 2014 to December 2015 were retrospectively analyzed (group B), and compared with that of 43 BA patients received open Kasai portoenterostomy (OKPE) during the same period (group C). In addition, 195 BA patients who had undergone LKPE during May 2009 to June 2014 were also included (group A).

Results

All 296 patients enrolled in this study were non-syndromic type III BA. Compared with group A, group B had shorter operative time (ORT) (P < 0.01) and fewer intraoperative blood transfusion (IOBT) (P < 0.05). The conversion rate and cholangitis rate were also significantly lower in group B than that in group A (P < 0.05). The postoperative oral intake resumed (POOR), any postoperative complications (APOC), clearance of jaundice (CJ), 1-year and 3-year survival rate with native liver (SNL) were not significantly different between group A and group B (P > 0.05). The ORT, IOBT, POOR, APOC, CJ, 1-year and 3-year SNL in group B were much better than that of group C (P < 0.05).

Conclusion

The MLKPE was associated with good perioperative with ORT, IOBT, POOR, and APOC. The short-term outcomes in MLKPE were no worse than that of OKPE and LKPE. MLKPE can be regarded as a treatment option for BA.

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Funding

This work was supported by grants from the National Natural Science Foundation of China (Grant Nos: 81401606 and 81400862), the Key Project in the Science & Technology Program of Sichuan Province (Grant No: 2019YFS0322), the Science Foundation for The Excellent Youth Scholars of Sichuan University (Grant No. 2015SU04A15), and the 1·3·5 project for disciplines of excellence–Clinical Research Incubation Project of West China Hospital of Sichuan University (2019HXFH056).

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Authors and Affiliations

  1. Department of Pediatric Surgery, West China Hospital of Sichuan University, #37 Guo-Xue-Xiang, Chengdu, 610041, China

    Yi Ji, Kaiying Yang, Shuguang Jin, Xiaoping Jiang & Zhicheng Xu

  2. Pediatric Intensive Care Unit, Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China

    Xuepeng Zhang & Siyuan Chen

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  1. Yi Ji
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  2. Kaiying Yang
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  7. Zhicheng Xu
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Correspondence to Zhicheng Xu.

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Yi Ji, Kaiying Yang, Xuepeng Zhang, Shuguang Jin, Xiaoping Jiang, Siyuan Chen, and Zhicheng Xu have no conflicts of interest or financial ties to disclose.

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Ji, Y., Yang, K., Zhang, X. et al. The short-term outcome of modified laparoscopic Kasai portoenterostomy for biliary atresia. Surg Endosc 35, 1429–1434 (2021). https://doi.org/10.1007/s00464-020-07530-7

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  • DOI: https://doi.org/10.1007/s00464-020-07530-7

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