Laparoscopic versus open Kasai procedure for biliary atresia: long-term results of a randomized clinical trial
Topic overview
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.
Key takeaways
- 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
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