Current management of biliary atresia based on 35 years of experience at a single center
Clinics
;
73: e289, 2018. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-952809
ABSTRACT
OBJECTIVE:
The prognosis of patients with biliary atresia undergoing Kasai portoenterostomy is related to the timing of the diagnosis and the indication for the procedure. The purpose of the present study is to present a practical flowchart based on 257 children who underwent Kasai portoenterostomy.METHODS:
We conducted a retrospective cohort study of patients who underwent Kasai portoenterostomy between 1981 and 2016.RESULTS:
During the first period (1981 to 2009), 230 infants were treated, and the median age at the time of surgery was 84 days; jaundice was resolved in 77 patients (33.5%). During the second period, from 2010 to 2016, a new diagnostic approach was adopted to shorten the wait time for portoenterostomy; an ultrasonography examination suggestive of the disease was followed by primary surgical exploration of the biliary tract without complementary examination or liver biopsy. Once the diagnosis of biliary atresia was confirmed, a portoenterostomy was performed during the same surgery. During this period, 27 infants underwent operations; the median age at the time of surgery was 66 days (p<0.001), and jaundice was resolved in 15 patients (55.6% - p=0.021), with a survival rate of the native liver of 66.7%.CONCLUSION:
Primary surgical exploration of the biliary tract without previous biopsy was effective at improving the prognostic indicators of patients with biliary atresia undergoing Kasai portoenterostomy.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Atresia Biliar
/
Portoenterostomía Hepática
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Femenino
/
Humanos
/
Lactante
/
Masculino
/
Recién Nacido
País/Región como asunto:
America del Sur
/
Brasil
Idioma:
Inglés
Revista:
Clinics
Asunto de la revista:
Medicina
Año:
2018
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Universidade de Sao Paulo/BR
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