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01.02.2016 | Original Article

Comprehensive assessment of prognosis after laparoscopic portoenterostomy for biliary atresia

verfasst von: Hiroki Nakamura, Hiroyuki Koga, Joel Cazares, Tadaharu Okazaki, Geoffrey J. Lane, Go Miyano, Manabu Okawada, Takashi Doi, Masahiko Urao, Atsuyuki Yamataka

Erschienen in: Pediatric Surgery International | Ausgabe 2/2016

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Abstract

Purpose

Total bilirubin (T-bil) is used universally for monitoring post-portoenterostomy (PE) biliary atresia (BA) patients although other biochemical markers [BM; AST/ALT and platelet count (PC)] are also prognostic. We compared open PE (OPE) with laparoscopic PE (LPE) using T-bil, AST/ALT, and PC (3BM) as more comprehensive indicators of postoperative clinical status.

Methods

Subjects were 31 PE cases (LPE: n = 17; OPE: n = 14). BA classification was type III (n = 16), type II (n = 1) in LPE and type III (n = 12), type I (n = 1), type II (n = 1) in OPE.

Results

Mean ages and weights at PE were similar: 65.5 days, 4.4 kg (LPE) versus 69.3 days, 4.1 kg (OPE); and mean follow-up was 2.5 years for both LPE and OPE. Jaundice clearance (T-bil ≤1.2 mg/dL) was achieved in 16/17 (94.1 %) after LPE versus 10/14 (71.4 %) after OPE (p = NS), but 3BM were closer to normal after OPE. At the time of review, 13/17 LPE cases (76.5 %) were alive with native livers and 4/17 had received LTx (23.5 %) and 10/14 OPE cases (71.4 %) were alive with native livers and 4/14 had received LTx (28.6 %).

Conclusions

Although JC was better after LPE, 3BM were better after OPE. Further follow-up will prove the comprehensive prognostic value of 3BM.

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Titel: Comprehensive assessment of prognosis after laparoscopic portoenterostomy for biliary atresia
verfasst von: Hiroki Nakamura
Hiroyuki Koga
Joel Cazares
Tadaharu Okazaki
Geoffrey J. Lane
Go Miyano
Manabu Okawada
Takashi Doi
Masahiko Urao
Atsuyuki Yamataka
Publikationsdatum: 01.02.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 2/2016
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-015-3820-y

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Comprehensive assessment of prognosis after laparoscopic portoenterostomy for biliary atresia