Short-Term Outcome of Infants with Biliary Artesia Following Kasai Portoenterostomy

OBJECTIVES: To assess the short-term outcome of Kasai portoenterostomy (KPE) in infants with biliary atresia (BA) and to identify the prognostic factors for successful KPE. METHODS: The study included 127 infants with BA who presented to the Pediatric Hepatology Unit, Cairo University over a period of 10 y. All patients were followed up for 6-mo post-KPE. Data retrieved from the patients' files included: history, clinical examination and investigations done at the time of presentation and after 6 mo of KPE. A successful outcome was defined as jaundice clearance after 6 mo of KPE. RESULTS: Age at KPE ranged from 30-180 d. Marked fibrosis was present more frequently among older patients. Eighty-seven patients (67%) had yellow-colored stools immediately after KPE. Jaundice clearance 6 mo after KPE was achieved in 40 patients (31.5%). Lower age at time of KPE was significantly associated with successful KPE (P = 0.03). Steroid therapy post-KPE did not show improvement in jaundice clearance. CONCLUSIONS: KPE had a 6-mo short term successful outcome in one-third of patients with BA. Younger age at KPE is an important prognostic factor to increase the rate of jaundice clearance. Steroids therapy failed to achieve a favorable outcome.