Long-term follow-up for anicteric survival with native liver after redo Kasai: a first report

详细信息    查看全文

• 作者：Hiroki Nakamura^a ; ^{hinakamu@juntendo.ac.jp} ; Takafumi Kawano^b ; Katsumi Yoshizawa^c ; Hideaki Nakajima^d ; Kazuto Suda^e ; Hiroyuki Koga^a ; Kazuhiko Nakame^b ; Satoshi Ieiri^b ; Shigeru Takamizawa^c ; Naoto Urushihara^d ; Toshihiro Yanai^e ; Atsuyuki Yamataka^a
• 关键词：Biliary atresia ; Redo-Kasai ; Morbidity ; Native liver
• 刊名：Journal of Pediatric Surgery
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：51
• 期：12
• 页码：2109-2112
• 全文大小：295 K
• 卷排序：51

文摘

We present a first report of the long-term follow-up of biliary atresia (BA) patients who became anicteric with the native liver (ANL; total bilirubin < 1.5 mg/dL) after redo-Kasai.MethodsForty-six redo-Kasai cases (1984–2015) were the subjects for this study. ANL ratios were determined using the Kaplan–Meier estimate.ResultsBA type was I (n = 3), II (n = 1), and III (n = 42). Mean ages (initial/redo) at Kasai were 60.3/231.9 days, respectively. Jaundice persisted after the initial Kasai in 24/46 cases while 22 had recurrence of jaundice after initially becoming anicteric. After redo, 5/24 of the persistent jaundice cases and 14/22 of the initially anicteric cases became anicteric (p < .05). Of these 19, 7 (one type I, six type III) are currently ANL while the remaining 12 had LTx or died. Morbidity/Complications documented in the 7 post-redo ANL cases after a mean follow-up of 16.7 years (range: 10.0–31.1) included 4 episodes of cholangitis, 3 episodes of portal hypertension, 4 episodes of esophageal varices, 3 episodes of splenomegaly, one splenectomy, and 4 episodes of thrombocytopenia.ConclusionsOurs is the first long-term follow-up study of redo-Kasai cases. We found that the ANL ratio after redo-Kasai was low at 7/46 (15.2%) and that ANL were prone to multiple morbidity.Level of evidenceRetrospective comparative study, level III.