Xu Sun1, Mei Diao2, Xuanzhao Wu3, Wei Cheng2, Mao Ye2, Long Li4. 1. Affiliated Hospital of Guiyang Medicine College, Guiyang City, Guizhou Province, PR China. 2. Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing 100020, PR China. 3. Affiliated Hospital of Guiyang Medicine College, Guiyang City, Guizhou Province, PR China. Electronic address: 413527005@qq.com. 4. Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing 100020, PR China. Electronic address: lilong22@hotmail.com.
Abstract
OBJECTIVE: The objective of the study is to evaluate the outcome of laparoscopic Kasai portoenterostomy for type III biliary atresia in children. METHODS: A total of 95 type III biliary atresia patients were treated at the Capital Institute of Pediatrics between September 2009 and August 2011. The patients were randomized into 2 groups preoperatively: the laparoscopic group (LPgroup, n=48) and the open group (OP group, n=47). In the LP group, 4 patients were converted to open operations, whereas the remaining 44 patients in the LP group and 47 patients in the OP group were included in the study. RESULTS: The gender distribution and age of the LP group did not differ from those of the OP group (LP group F/M 21/23, median age 61.5days, OP group F/M 24/23, median age 67days, P=0.75 and 0.11). The operation time in the LP group was significantly longer than that in the OP group (median 169.5min vs 146min, P<0.01). Intraoperative blood loss in the LP group was significantly lower than in the OP group (median 10ml vs 15ml, P<0.01). The resumption oral intake was significantly faster in the LP group than in the OP group (median 3days vs 3days, P<0.01). There were no significant differences between the postoperative hospital stay in the two groups (median 12.5days vs 13days, P=0.21). The median follow-up period was 16months in the LP group and 17months in the OP group. There was no statistically significant difference in the jaundice clearance rate at the end of the third postoperative month or in the incidence of cholangitis, native liver survival rate, and liver function recovery between the 2 groups. CONCLUSIONS: The short-term and mid-term results are comparable between the laparoscopic and open Kasai portoenterostomy groups. The laparoscopic Kasai procedure does not improve the prognosis of biliary atresia.
RCT Entities:
OBJECTIVE: The objective of the study is to evaluate the outcome of laparoscopic Kasai portoenterostomy for type III biliary atresia in children. METHODS: A total of 95 type III biliary atresiapatients were treated at the Capital Institute of Pediatrics between September 2009 and August 2011. The patients were randomized into 2 groups preoperatively: the laparoscopic group (LP group, n=48) and the open group (OP group, n=47). In the LP group, 4 patients were converted to open operations, whereas the remaining 44 patients in the LP group and 47 patients in the OP group were included in the study. RESULTS: The gender distribution and age of the LP group did not differ from those of the OP group (LP group F/M 21/23, median age 61.5days, OP group F/M 24/23, median age 67days, P=0.75 and 0.11). The operation time in the LP group was significantly longer than that in the OP group (median 169.5min vs 146min, P<0.01). Intraoperative blood loss in the LP group was significantly lower than in the OP group (median 10ml vs 15ml, P<0.01). The resumption oral intake was significantly faster in the LP group than in the OP group (median 3days vs 3days, P<0.01). There were no significant differences between the postoperative hospital stay in the two groups (median 12.5days vs 13days, P=0.21). The median follow-up period was 16months in the LP group and 17months in the OP group. There was no statistically significant difference in the jaundice clearance rate at the end of the third postoperative month or in the incidence of cholangitis, native liver survival rate, and liver function recovery between the 2 groups. CONCLUSIONS: The short-term and mid-term results are comparable between the laparoscopic and open Kasai portoenterostomy groups. The laparoscopic Kasai procedure does not improve the prognosis of biliary atresia.
Authors: David Eugenio Hinojosa-Gonzalez; Luis C Bueno; Andres Roblesgil-Medrano; Gustavo Salgado-Garza; Sofia Hurtado-Arellano; Juan S Farias; Mauricio Torres-Martinez; Jaime A Escarcega-Bordagaray; Marcelo Salan-Gomez; Eduardo Flores-Villalba Journal: Pediatr Surg Int Date: 2021-07-16 Impact factor: 1.827