The Characteristics of Patients Who Failed Initial Kasai Portoenterostomy and the Long-term Prognosis of Those Who Underwent Redo-Kasai: a Retrospective Observational Study

Overview

Journal Ann Surg Treat Res

Specialty General Surgery

Date 2025 Feb 13

PMID 39944925

Authors

Suhyeon Ha

Sujin Gang

Jueun Park

Hyunhee Kwon

Dae Yeon Kim

Seong Chul Kim

Jung-Man Namgoong

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to determine the characteristics of patients with failed initial Kasai portoenterostomy (KP) and to compare the long-term prognosis of redo-KP with that of liver transplantation (LT) in these patients.

Methods: The medical records of patients with biliary atresia (BA) who failed initial KP from 2010 to 2021 at a single center were retrospectively analyzed. KP failure was defined as persistent jaundice (total bilirubin concentration, ≥2.0 mg/dL) after KP or the performance of LT.

Results: During the study period, 32 patients experienced initial KP failure, with 10 undergoing redo-KP and 22 undergoing LT. Redo-KP was successful in a minority of patients with failed initial KP, but the complications, particularly cholangitis, were more frequent in the redo-KP group. The long-term prognosis of redo-KP compared to LT showed that while some patients benefited from native liver survival after redo-KP, LT remains the more definitive solution for sustained liver function and survival in patients with BA.

Conclusion: The only factor differing significantly between patients who underwent redo-KP and LT after failed initial KP was complications of cholangitis. Redo-KP was successful in 4 of 10 patients with failed initial KP, suggesting that redo-KP may be a treatment option in patients with BA and failed initial KP.

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