Comparison of drainage techniques for biliary atresia.


Journal Article

PURPOSE:Traditional Kasai portoenterostomy and porto-appendiceal duodenostomy have been utilized for biliary atresia. Differences in outcome between patients who underwent either Kasai portoenterostomy or porto-appendiceal duodenostomy were compared. METHODS:A review of all children who underwent a drainage procedure for biliary atresia from 1986 to 2000 (n = 30) was performed. Age at drainage procedure, subsequent liver transplantation, and outcomes were evaluated. Outcome variables included success rates (total bilirubin < 2.0 mg/dL) and survival rate. Statistical analysis was done with chi2 and Student's t test. RESULTS:Long-term follow-up was available on 28 of 30 patients. Age at biliary drainage was insignificant. Success rates between porto-appendiceal duodenostomy (31%) and Kasai portoenterostomy (82%) were statistically significant. Survival rate for patients who underwent a Kasai portoenterostomy was 10 of 11 patients. Survival rate for patients who underwent porto-appendiceal duodenostomy was 14 of 16 patients. Overall survival rate was comparable between porto-appendiceal duodenostomy (88%) and Kasai portoenterostomy (91%). CONCLUSIONS:Although overall survival rate was comparable, patients who underwent porto-appendiceal duodenostomy were less successful in alleviating hyperbilirubinemia compared with Kasai portoenterostomy. This is shown further by the greater incidence of subsequent liver transplantation in infants with prior porto-appendiceal duodenostomy. Although the appendix may serve as an alternative biliary conduit, traditional Kasai portoenterostomy appears to achieve better biliary drainage.

Full Text

Cited Authors

  • Tsao, K; Rosenthal, P; Dhawan, K; Danzer, E; Sydorak, R; Hirose, S; Farmer, DL; Albanese, CT; Harrison, MR; Lee, H

Published Date

  • July 2003

Published In

Volume / Issue

  • 38 / 7

Start / End Page

  • 1005 - 1007

PubMed ID

  • 12861527

Pubmed Central ID

  • 12861527

Electronic International Standard Serial Number (EISSN)

  • 1531-5037

International Standard Serial Number (ISSN)

  • 0022-3468

Digital Object Identifier (DOI)

  • 10.1016/s0022-3468(03)00180-5


  • eng