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A periodic comparison of the survival and prognostic factors of biliary atresia after Kasai portoenterostomy: a single-center study in Korea

 Kyong Ihn  ;  Younghyun Na  ;  In Geol Ho  ;  Dongeun Lee  ;  Hong Koh  ;  Seok Joo Han 
 PEDIATRIC SURGERY INTERNATIONAL, Vol.35(3) : 285-292, 2019 
Journal Title
Issue Date
Biliary Atresia/diagnosis ; Biliary Atresia/mortality ; Biliary Atresia/surgery ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Portoenterostomy, Hepatic/methods ; Prognosis ; Republic of Korea/epidemiology ; Retrospective Studies ; Survival Rate/trends
Biliary atresia ;  Kasai portoenterostomy ; Liver fibrosis ; Native liver survival ; Prognosis
PURPOSE: We explored the chronologic changes in prognostic factors and clinical outcomes of Kasai portoenterostomy (KPE) for biliary atresia (BA). METHODS: Patients undergoing KPE between 1997 and 2016 were analyzed retrospectively. Ninety-two consecutive patients who underwent KPE from 1997 to 2006 (Era 1) were compared with 150 patients who underwent KPE from 2007 to 2016 (Era 2) for clinical outcomes and prognostic factors. RESULTS: The jaundice clearance rate increased by 8.8% (66.7% vs. 75.5% for Eras 1 and 2, respectively, p = 0.180), and the 5-year native liver survival (NLS) rate improved slightly (62.5% vs. 64.0% for Eras 1 and 2, respectively, p = 0.617) in Era 2. The hazard ratio for age at KPE (≥ 90 days) with regard to 5-year NLS and the odds ratio for age at KPE (< 90 days) with regard to jaundice clearance were both lower in Era 2 than in Era 1 (1.95 vs. 2.25 and 2.67 vs. 5.21, respectively). CONCLUSION: The clinical outcomes improved over a period in a single surgeon's practice. We demonstrated that the impact of age at the time of KPE on operative outcomes became less significant over time with the increase in the single surgeon's experience and improvement in medical treatment for BA.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
7. Others (기타) > Others (기타) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Lee, Dongeun(이동은)
Ihn, Kyong(인경) ORCID logo https://orcid.org/0000-0002-6161-0078
Han, Seok Joo(한석주) ORCID logo https://orcid.org/0000-0001-5224-1437
Hu, Jen Chien(호인걸)
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