Effect of microscopy-assisted portoenterostomy (MAPE) for biliary atresia
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Jan 2021 · 1 min read
In brief
In brief
This study evaluates microscopy-assisted portoenterostomy (MAPE) for biliary atresia, comparing outcomes with conventional technique. MAPE achieved 80% jaundice clearance versus 53% with conventional PE, and showed promise in revision cases with 75% clearance rate and improved native liver survival at 4 years.
Written by the GCMD Library team from the article.
Abstract
Purpose
Portoenterostomy (PE) is the standard treatment for biliary atresia (BA). However, micro-bile ducts are difficult to identify with surgical loupes and dissect systematically. We report the effects of our attempts to dissect hilar tissue using a surgical microscope.
Methods
Microscopy-assisted portoenterostomy (MAPE) was initiated in 2014. Patients born between 2000 and 2013 who underwent PE until day 70 without a surgical microscope for BA were gathered as historical control. MAPE in re-do PE cases (Re-MAPE) was evaluated in the same manner.
Results
Ten patients underwent MAPE for BA during the study period. 17 patients in the conventional PE group were gathered. In the MAPE group, the jaundice clearance rate was 80%, compared with 53% in the conventional PE group. Re-MAPE was performed in four patients, who had a jaundice clearance rate of 75%, essentially identical to the rate with initial MAPE. At age 4 years, the native liver survival rate was 58% in the MAPE group and 38% in the conventional PE group. The native liver survival rate in the Re-MAPE group was 75%.
Conclusion
MAPE is useful for sharing the surgical field during open PE in patients with BA. It may improve the rate of jaundice clearance.