Long-Term Outcome of Children with Biliary Atresia after Kasei Surgery in Iranian Infants
Mastaneh Moghtaderi*, Mojtaba Gorji, Fatemeh Farahmand, Golamhosein Fallahi and Bahar Ashjai
Department of Pediatrics, Tehran University of Medical Science, Iran
- *Corresponding Author:
- Mastaneh Moghtaderi, Professor
Department of Pediatrics
Division of Pediatric Nephrology
Children Medical Center Hospital
Tehran University of Medical Science
Gharib St., Tehran, Iran
E-mail: [email protected]
Received Date: Oct 02, 2015, Accepted Date: Feb 25, 2016, Published Date: Feb 29, 2016
Citation: Moghtaderi M, Gorji M, Farahmand F, Fallahi G, Ashjai B (2016) Long-Term Outcome of Children with Biliary Atresia after Kasei Surgery in Iranian Infants. Pediatr Ther 6:279. doi:10.4172/2161-0665.1000279
Copyright: © 2016 Moghtaderi M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Aim: The aims of the present study were to evaluate the long-term prognosis of children with biliary atresia after the Kasai surgery and to analyze the present status of survivors retaining their own liver function.
Background: Biliary atresia is the most common cause of pathologic infantile jaundice that results from obstructions of extra hepatic bile ducts due to inflammation and fibrosis. It is a progressive disorder and gradually results in cirrhosis, portal hypertension and hepatic failure. The disease progression to cirrhosis and hepatic failure could be prevented with Kasai surgery.
Method and patients: This is a descriptive retrospective cohort study in which we evaluated patients with biliary atresia who admitted between 1998 and 2008 and underwent Kasai surgical procedure.
Results: A total of 49 patients had Kasai surgery. Patients’ survival rates were 14.3%, 8.1% and 2.1%, 2-5, 5-10 and >10 years after the surgery, respectively. The incidence of cholangitis was 59.1% and gastrointestinal bleeding 38.7% following the surgery. Four patients had liver transplantation (8.1%) and only 2 survived (50%). The survival rates varied significantly depending on the age at Kasai operation. Of the 10 patients who underwent Kasai procedure during the first 8 weeks of life, 6 survived (60%) and 4 died. Of the 23 patients who had Kasai surgery between 8-12 weeks of life, 4 survived (17.3%) and 19 (82.6%) died. Of the 16 patients who had kasai operation after 12 weeks of life, 2 survived (12.5%) and 14 (87.5%) died.
Conclusion: This clinical trial confirms previous studies that Kasai surgery is an effective procedure for the treatment of children with biliary atresia and that the long-term survival rate can be improved if Kasai operation is performed before the first 8 weeks of life.