Skip to main content
Erschienen in: Pediatric Surgery International 7/2011

01.07.2011 | Original Article

The outcome of laparoscopic portoenterostomy for biliary atresia in children

verfasst von: Kin Wai Edwin Chan, Kim Hung Lee, Jennifer Wai Cheung Mou, Sing Tak Gloria Cheung, Yuk Him Peter Tam

Erschienen in: Pediatric Surgery International | Ausgabe 7/2011

Einloggen, um Zugang zu erhalten

Abstract

Aim

There were only a few reports on laparoscopic portoenterostomy for biliary atresia in children. We report our experience on laparoscopic Kasai operation for biliary atresia.

Material and methods

A retrospective review of all children who had biliary atresia underwent laparoscopic portoenterostomy from January 2002 to September 2006 were included and analyzed.

Results

Sixteen children (five boys and eleven girls) with a mean age of 66 days (range 47–106 days) at operation were included in this study. All patients had type III biliary atresia. There was no conversion to open procedure. The operative time ranged from 193 to 435 min (mean 292 min). At a median follow-up of 72 months (range 33–89 months), eight patients were free of jaundice with bilirubin level <20 μmol/L and did not require liver transplantation. Seven patients underwent liver transplantation. One patient who had persistent elevated bilirubin defaulted follow-up. One patient complicated with volvulus of intestine post-operatively. All patients survived except one patient who had combined liver and intestine transplantation.

Conclusion

Laparoscopic portoenterostomy in children with biliary atresia is technically feasible. 50% of children who had type III biliary atresia were free of jaundice and did not require liver transplantation. A longer follow-up is required to assess the long-term outcome.
Literatur
1.
Zurück zum Zitat Balistreri WF (2004) Pediatric hepatology. A half-century of progress. Clin Liver Dis 4:191–210CrossRef Balistreri WF (2004) Pediatric hepatology. A half-century of progress. Clin Liver Dis 4:191–210CrossRef
2.
Zurück zum Zitat Nio M, Ohi R, Miyano T et al (2003) Five and 10-year survival rates after surgery for biliary atresia: a report from the Japanese Biliary Atresia Registry. J Pediatr Surg 38:997–1000PubMedCrossRef Nio M, Ohi R, Miyano T et al (2003) Five and 10-year survival rates after surgery for biliary atresia: a report from the Japanese Biliary Atresia Registry. J Pediatr Surg 38:997–1000PubMedCrossRef
3.
Zurück zum Zitat McKiernan PJ, Baker AJ, Kelly DA (2000) The frequency and outcome of biliary atresia in the UK and Ireland. Lancet 355:25–29PubMedCrossRef McKiernan PJ, Baker AJ, Kelly DA (2000) The frequency and outcome of biliary atresia in the UK and Ireland. Lancet 355:25–29PubMedCrossRef
4.
5.
Zurück zum Zitat Tan HL (1999) Laparoscopic Anderson-Hynes dismembered pyeloplasty in children. J Urol 162:1045–1047PubMedCrossRef Tan HL (1999) Laparoscopic Anderson-Hynes dismembered pyeloplasty in children. J Urol 162:1045–1047PubMedCrossRef
6.
Zurück zum Zitat Li L, Feng W, Jing-Bo F et al (2004) Laparoscopic-assisted total cyst excision of choledochal cyst and Roux-en-Y hepatoenterostomy. J Pediatr Surg 39:1663–1666PubMedCrossRef Li L, Feng W, Jing-Bo F et al (2004) Laparoscopic-assisted total cyst excision of choledochal cyst and Roux-en-Y hepatoenterostomy. J Pediatr Surg 39:1663–1666PubMedCrossRef
7.
Zurück zum Zitat Esteves E, Clemente Neto E, Ottaiano Neto M et al (2002) Laparoscopic Kasai portoenterostomy for biliary atresia. Pediatr Surg Int 18:737–740PubMed Esteves E, Clemente Neto E, Ottaiano Neto M et al (2002) Laparoscopic Kasai portoenterostomy for biliary atresia. Pediatr Surg Int 18:737–740PubMed
8.
Zurück zum Zitat Lee H, Hirose S, Bratton B et al (2004) Initial experience with complex laparoscopic biliary surgery in children: biliary atresia and choledochal cyst. J Pediatr Surg 39:804–807PubMedCrossRef Lee H, Hirose S, Bratton B et al (2004) Initial experience with complex laparoscopic biliary surgery in children: biliary atresia and choledochal cyst. J Pediatr Surg 39:804–807PubMedCrossRef
9.
Zurück zum Zitat Martinez-Ferro M, Esteves E, Laje P (2005) Laparoscopic treatment of biliary atresia and choledochal cyst. Semin Pediatr Surg 14:206–215PubMedCrossRef Martinez-Ferro M, Esteves E, Laje P (2005) Laparoscopic treatment of biliary atresia and choledochal cyst. Semin Pediatr Surg 14:206–215PubMedCrossRef
10.
Zurück zum Zitat Aspelund G, Ling SC, Ng V et al (2007) A role for laparoscopic approach in the treatment of biliary atresia and choledochal cysts. J Pediatr Surg 42:869–872PubMedCrossRef Aspelund G, Ling SC, Ng V et al (2007) A role for laparoscopic approach in the treatment of biliary atresia and choledochal cysts. J Pediatr Surg 42:869–872PubMedCrossRef
11.
Zurück zum Zitat Dutta S, Woo R, Albanese CT (2007) Minimal access portoenterostomy: advantages and disadvantages of standard laparoscopic and robotic techniques. J Laparoendosc Adv Surg Tech A 17:258–264PubMedCrossRef Dutta S, Woo R, Albanese CT (2007) Minimal access portoenterostomy: advantages and disadvantages of standard laparoscopic and robotic techniques. J Laparoendosc Adv Surg Tech A 17:258–264PubMedCrossRef
12.
Zurück zum Zitat Kasai M, Suzuki S (1959) A new operation for ‘‘non-correctable’’ biliary atresia: hepatic portoenterostomy. Shujjutsu 13:733 Kasai M, Suzuki S (1959) A new operation for ‘‘non-correctable’’ biliary atresia: hepatic portoenterostomy. Shujjutsu 13:733
13.
Zurück zum Zitat Sokol RJ, Mack C, Narkewicz MR et al (2003) Pathogenesis and outcome of biliary atresia: current concepts. J Pediatr Gastroenterol Nutr 37:4–21PubMedCrossRef Sokol RJ, Mack C, Narkewicz MR et al (2003) Pathogenesis and outcome of biliary atresia: current concepts. J Pediatr Gastroenterol Nutr 37:4–21PubMedCrossRef
14.
Zurück zum Zitat Davenport M, De Ville de Goyet J, Stringer MD et al (2004) Seamless management of biliary atresia in England and Wales (1999–2002). Lancet 363:1354–1357PubMedCrossRef Davenport M, De Ville de Goyet J, Stringer MD et al (2004) Seamless management of biliary atresia in England and Wales (1999–2002). Lancet 363:1354–1357PubMedCrossRef
15.
Zurück zum Zitat Hung PY, Chen CC, Chen WJ et al (2006) Long-term prognosis of patient with biliary atresia: a 25 year summary. J Pediatr Gastroenterol Nutr 42:190–195PubMedCrossRef Hung PY, Chen CC, Chen WJ et al (2006) Long-term prognosis of patient with biliary atresia: a 25 year summary. J Pediatr Gastroenterol Nutr 42:190–195PubMedCrossRef
16.
Zurück zum Zitat Utterson EC, Shepherd RW, Sokol RJ et al (2005) Biliary atresia: clinical profiles, risk factors, and outcomes of 755 patients listed for liver transplantation. J Pediatr 147:180–185PubMedCrossRef Utterson EC, Shepherd RW, Sokol RJ et al (2005) Biliary atresia: clinical profiles, risk factors, and outcomes of 755 patients listed for liver transplantation. J Pediatr 147:180–185PubMedCrossRef
17.
Zurück zum Zitat Chan KW, Lee KH, Tam YH et al (2007) Minimal invasive surgery in pediatric solid tumors. J Laparoendosc Adv Surg Tech A 17(6):817–820PubMedCrossRef Chan KW, Lee KH, Tam YH et al (2007) Minimal invasive surgery in pediatric solid tumors. J Laparoendosc Adv Surg Tech A 17(6):817–820PubMedCrossRef
18.
Zurück zum Zitat Chan KW, Chow CS, Tam YH et al (2007) Laparoscopy: an excellent tool in the management of primary omental torsion in children. J Laparoendosc Adv Surg Tech A 17(6):821–824PubMedCrossRef Chan KW, Chow CS, Tam YH et al (2007) Laparoscopy: an excellent tool in the management of primary omental torsion in children. J Laparoendosc Adv Surg Tech A 17(6):821–824PubMedCrossRef
19.
Zurück zum Zitat Chan KW, Lee KH, Mou JW et al (2008) Laparoscopic management of complicated Meckel’s diverticulum in children: a 10-year review. Surg Endosc 22(6):1509–1512PubMedCrossRef Chan KW, Lee KH, Mou JW et al (2008) Laparoscopic management of complicated Meckel’s diverticulum in children: a 10-year review. Surg Endosc 22(6):1509–1512PubMedCrossRef
20.
Zurück zum Zitat Houben CH, Chan M, Cheung G et al (2006) A hepaticojejunostomy: technical errors with ‘twists and turns’. Pediatr Surg Int 22(10):841–844PubMedCrossRef Houben CH, Chan M, Cheung G et al (2006) A hepaticojejunostomy: technical errors with ‘twists and turns’. Pediatr Surg Int 22(10):841–844PubMedCrossRef
21.
22.
Zurück zum Zitat Van Heurn ELW, Saing H, Tam PK (2004) The portoenterostomy for biliary atresia: long-term survival and prognosis after esophageal variceal bleeding. J Pediatr Surg 39:6–9PubMedCrossRef Van Heurn ELW, Saing H, Tam PK (2004) The portoenterostomy for biliary atresia: long-term survival and prognosis after esophageal variceal bleeding. J Pediatr Surg 39:6–9PubMedCrossRef
Metadaten
Titel
The outcome of laparoscopic portoenterostomy for biliary atresia in children
verfasst von
Kin Wai Edwin Chan
Kim Hung Lee
Jennifer Wai Cheung Mou
Sing Tak Gloria Cheung
Yuk Him Peter Tam
Publikationsdatum
01.07.2011
Verlag
Springer-Verlag
Erschienen in
Pediatric Surgery International / Ausgabe 7/2011
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-011-2859-7

Weitere Artikel der Ausgabe 7/2011

Pediatric Surgery International 7/2011 Zur Ausgabe

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.