Laparoscopic versus open Kasai procedure for biliary atresia: long-term results of a randomized clinical trial
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Apr 2023 · 1 min read
In brief
In brief
This randomized trial of 122 biliary atresia patients compared laparoscopic versus open Kasai procedures over 10+ years. While jaundice-free rates at 6 months were similar (52.5% vs 60.7%), the laparoscopic approach showed a trend toward lower 10-year survival (44.3% vs 58.9%, p=0.09), suggesting open surgery may remain the preferred approach.
Written by the GCMD Library team from the article.
Purpose: The role of the laparoscopic approach for the Kasai procedure in the management of biliary atresia is still controversial. The aim of this study is to compare the long-term results of the laparoscopic Kasai procedure (LKP) to the open Kasai procedure (OKP).
Methods: A randomized clinical trial was carried out from October 2009 to March 2017. Patients diagnosed with biliary atresia type III were randomized into 2 groups: one group underwent LKP and the other group-OKP. All the surgical procedures were performed by the same surgeon with the same technical principles. The long-term outcomes were compared between the two groups.
Results: 61 patients underwent LKP and 61 patients-OKP, with a median age at the surgery of 79.7 days. The two groups had no significant differences regarding the patients' baseline characteristics. At follow-up up to 142 months, the jaundice-free rate at the 6th postoperative month for LKP and OKP was 52.5% and 60.7%, respectively (p = 0.23). The 10-year cumulative survival after LKP tended to be inferior to OKP, respectively 44.3% vs. 58.9% (p = 0.09).
Conclusions: In this study, the long-term results of LKP tended to be inferior compared to OKP although the differences were not significant.
DOI: 10.1007/s00383-023-05391-4