StayCurrentMD · Kasai Procedure in Patients Older Than 90 Days: Worth a Cut
Article1 min read·Published Dec 2021Older

Kasai Procedure in Patients Older Than 90 Days: Worth a Cut

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Article · Dec 2021 · 1 min read

In brief

In brief

This retrospective study examines outcomes of Kasai portoenterostomy performed in biliary atresia patients older than 90 days, challenging the conventional wisdom that late presentation mandates primary liver transplantation. The analysis of 11 patients (mean age 108 days) evaluates jaundice clearance and native-liver survival to inform surgical decision-making in delayed-diagnosis cases.

Written by the GCMD Library team from the article.

Introduction Age at Kasai portoenterostomy (KPE) has been identified as a predictive factor for native-liver survival in patients with biliary atresia (BA). Outcomes of pediatric liver transplantation (LT) have improved over recent years. It has been proposed to consider primary LT as a treatment option for late-presenting BA infants instead of attempting KPE. We present our experience with patients older than 90 days undergoing KPE.

Materials and Methods A retrospective chart review of patients with BA undergoing KPE at our institution between January 2010 and December 2020 was performed. Patients 90 days and older at the time of surgery were included. Patients' characteristics, perioperative data, and follow-up results were collected. Eleven patients matched the inclusion criteria. Mean age at KPE was 108 days (range: 90–133 days).

Results Postoperative jaundice clearance (bilirubin 

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