Laparoscopic versus open Kasai procedure for biliary atresia: long-term results of a randomized clinical trial
Document · Jul 2023 · 1 min read
In brief
In brief
Randomized trial comparing laparoscopic versus open Kasai portoenterostomy in 122 biliary atresia patients followed up to 142 months. Laparoscopic approach showed comparable jaundice clearance rates but trended toward lower 10-year survival (44.3% vs 58.9%, p=0.09), suggesting open technique may remain preferred for this complex hepatobiliary procedure.
- Laparoscopic Kasai showed no significant difference in 6-month jaundice clearance vs open (52.5% vs 60.7%, p=0.23)
- 10-year survival trended lower with laparoscopic approach (44.3% vs 58.9%, p=0.09) though not statistically significant
- Median age at surgery was 79.7 days; both techniques performed by same surgeon using identical principles
- Long-term outcomes of laparoscopic Kasai may be inferior to open approach for biliary atresia type III
- Study represents longest follow-up (up to 142 months) comparing laparoscopic vs open Kasai in randomized trial
Written by the GCMD Library team from the document.
Tran N Son, Duong V Mai, Pham T Tung, Nguyen T Liem
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.