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Background: Kasai’s portoenterostomy has gained worldwide acceptance as the initial surgical therapy for infants with biliary atresia. Although extended survival has been achieved for many patients, factors influencing outcome have not been defined clearly. The goals of this article are to define long-term outcome and to investigate prognostic factors after Kasai’s portoenterostomy of biliary atresia using univariate and multivariable methods.
Patient and Methods: This retrospective study was done in 56 cases of biliary atresia that received Kasai operation at Department of Pediatric Surgery, Keimyung university hospital between 1991 and 2005. Kaplan-Meier method, Log-rank test and Cox Regression test were used for statistical analysis.
Results: The 5-year survival rate after Kasai was 77.2%. There were statistically significant differences in positive prognostic factors after Kasai in following conditions; the age of the patient at the time of surgery < 90 days, serum direct bilirubin level on admission > 7mg/dL, bilirubin clearance in the 6 months after Kasai operation and absence of cholangitis within 6 months after operation.
Conclusion: The bilirubin clearance within 6 months after Kasai operation and the density of bile ductule in periportal fibrous mass is independent risk factor for 5-year survival rate without liver transplantation. The prognosis is better in condition with normal biliary drainage and the density of bile ductule in periportal fibrous mass over 7.4http://kumel.medlib.dsmc.or.kr/handle/2015.oak/11644z3:\k'
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