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Pediatric Surgery International

Erschienen in:

04.03.2022 | Original Article

Mid-term outcome of postoperative biliary atresia patients according to level of transection of the biliary remnant and depth of suturing

verfasst von: Eri Abe, Hiroyuki Koga, Hiroki Nakamura, Takanori Ochi, Shogo Seo, Geoffrey J. Lane, Atsuyuki Yamataka

Erschienen in: Pediatric Surgery International | Ausgabe 5/2022

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Abstract

Purpose

Open portoenterostomy (PE) for biliary atresia (BA) is currently more extended (EP) than the original (OP). Typical OP techniques, shallow transection of the biliary remnant and shallow suturing, both lost in EP, were revived as a modified procedure (MP). Postoperative outcomes of EP and MP were compared.

Methods

Subjects were 55 consecutive BA patients treated by EP (n = 18) or MP (n = 37) at a single center between 2004 and 2021.

Results

Mean follow-up duration was: MP: 15.5 years (range 0.1–12.3 years) and EP: 15.5 years (range 0.38–17.1 years). The ratio of jaundice free (JF; total bilirubin ≤ 1.2 mg/dL) subjects was significantly higher in MP (78.4%) versus EP (50%); p > 0.05, the incidence of bile lakes at the porta hepatis was significantly higher in MP (7/37: 18.9%) versus EP (0/18: 0%); p > 0.05, and Kaplan–Meier analysis showed JF survival with the native liver (JF + SNL) was significantly better in MP (26/37: 70.2%) versus EP (4/18: 22.2%); p > 0.05. All other criteria were similar. Of note, time taken to become JF and the incidence of cholangitis were not significantly different.

Conclusions

Shallow transection and shallow suturing would appear to influence postoperative outcome. The etiology of bile lake formation in MP requires urgent confirmation.

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Titel: Mid-term outcome of postoperative biliary atresia patients according to level of transection of the biliary remnant and depth of suturing
verfasst von: Eri Abe
Hiroyuki Koga
Hiroki Nakamura
Takanori Ochi
Shogo Seo
Geoffrey J. Lane
Atsuyuki Yamataka
Publikationsdatum: 04.03.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 5/2022
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-022-05097-z

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Mid-term outcome of postoperative biliary atresia patients according to level of transection of the biliary remnant and depth of suturing