Laparoscopic Versus Open Kasai Procedure for Biliary Atresia: Long-term Results of a Randomized Clinical Trial

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2023 Feb 10

PMID 36763200

Authors

Tran N Son

Duong V Mai

Pham T Tung

Nguyen T Liem

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Comparison of different Kasai portoenterostomy techniques in the outcomes of biliary atresia: a systematic review and network meta-analysis.

Zhang Y, Liu S, Yang Q, Sun R, Liu J, Meng Y Pediatr Surg Int. 2024; 41(1):6.

PMID: 39592482 DOI: 10.1007/s00383-024-05920-9.

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