Comprehensive assessment of prognosis after laparoscopic portoenterostomy for biliary atresia

Nakamura, Hiroki; Koga, Hiroyuki; Cazares, Joel; Okazaki, Tadaharu; Lane, Geoffrey J.; Miyano, Go; Okawada, Manabu; Doi, Takashi; Urao, Masahiko; Yamataka, Atsuyuki

doi:10.1007/s00383-015-3820-y

Cited by 19 publications

(3 citation statements)

References 17 publications

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“…Twenty-nine studies (1 RCT and 28 NRSs) dealt with four types of procedures, such as Kasai's portoenterostomy (1 RCT 191 and 13 NRSs 192 193 194 195 196 197 198 199 200 201 202 203 204 ), choledochal cyst resection (11 NRSs 192 205 206 207 208 209 210 211 212 213 214 ), cholecystectomy (3 NRSs 215 216 217 ), and hydatid liver cyst resection (1 NRS 218 ). The results are summarized in Table 4 .…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic versus Open Pediatric Surgery: Three Decades of Comparative Studies

et al. 2021

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Introduction Despite its wide acceptance, the superiority of laparoscopic versus open pediatric surgery has remained controversial. There is still a call for well-founded evidence. We reviewed the literature on studies published in the last three decades and dealing with advantages and disadvantages of laparoscopy compared to open surgery. Materials and Methods Studies comparing laparoscopic versus open abdominal procedures in children were searched in PubMed/MEDLINE. Reports on upper and lower gastrointestinal as hepatobiliary surgery and on surgery of pancreas and spleen were included. Advantages and disadvantages of laparoscopic surgery were analyzed for different types of procedures. Complications were categorized using the Clavien–Dindo classification. Results A total of 239 studies dealing with 19 types of procedures and outcomes in 929,157 patients were analyzed. We identified 26 randomized controlled trials (10.8%) and 213 comparative studies (89.2%). The most frequently reported advantage of laparoscopy was shorter hospital stay in 60.4% of studies. Longer operative time was the most frequently reported disadvantage of laparoscopy in 52.7% of studies. Clavien–Dindo grade I to III complications (mild–moderate) were less frequently identified in laparoscopic compared to open procedures (80.3% of studies). Grade-IV complications (severe) were less frequently reported after laparoscopic versus open appendectomy for perforated appendicitis and more frequently after laparoscopic Kasai's portoenterostomy. We identified a decreased frequency of reporting on advantages after laparoscopy and increased reporting on disadvantages for all surgery types over the decades. Conclusion Laparoscopic compared with open pediatric surgery seems to be beneficial in most types of procedures. The number of randomized controlled trials (RCTs) remains limited. However, the number of reports on disadvantages increased during the past decades.

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Section: Resultsmentioning

confidence: 99%

Laparoscopic versus Open Pediatric Surgery: Three Decades of Comparative Studies

et al. 2021

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“…По данным группы ученых (Wang B, Feng Q, 2014) процент годичной выживаемости детей с нативной печенью является самым высоким именно в этой группе пациентов и составляет 84%, также частота встречаемости холангитов в послеоперационном периоде достаточно низкая и составляет 28% [62]. Схожие результаты представляют (Nakamuro et al, 2016): годичная выживаемость с нативной печенью составляет 76,5%, но частоту встречаемости холангитов в данном исследовании он не отслеживает [52]. В работе Chardot [43] при II типе БА 5-ти летняя выживаемость составила 60,9%.…”

Section: анатомо-морфологические особенности баunclassified

Modern Approaches to the Surgical Treatment of Biliary Atresia

Разумовский

Ratnikov

2018

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The review of literature deals with the current classification of the biliary atresia, presents the authors’ opinion considering a technique of theKasaiprocedure, and displays modern modifications of portoenteroanastomosis estimating their effectiveness. PubMed database and Google Scholar search system were used to search for primary terms. Survival of children with this pathology was analyzed depending on theKasaitechnique, anatomical form, terms of portoenteroanastomosis and importance of early diagnosis of this pathology.

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“…SBM used were AST and ALT as indicators of liver cell damage [16], T-Bil, and platelet count (PLT) as an indicator of hypersplenism [17] secondary to the histopathologic progression of BA. Changes observed in SBM were similar for LPE and OPE [18]. Data were obtained prospectively from blood biochemistry assessed at the last outpatient clinic attendance made by each postoperative BA subject, so clinical status was assessed at a single point in time that varied between subjects.…”

Section: Introductionmentioning

confidence: 99%

Biochemical Evaluation of Laparoscopic Portoenterostomy for Treating Biliary Atresia and Redo for Failed Portoenterostomy

Tsukui

Koga

Cazares

et al. 2022

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: Postoperative outcomes of portoenterostomy (PE) and redo-PE were evaluated using selected biochemical markers (SBM) and biochemical status categories (BSC). Methods: Subjects were 70 consecutive PE performed for biliary atresia. SBM were aspartate aminotransferase (AST)/alanine aminotransferase (ALT), cholinesterase (ChE), and platelet count (PLT) assessed at 1, 2, 3, 6, and 12 months, thence annually for a maximum of 10 years. BSC were: all SBM normal (N-SBM), normal AST/ALT (N-SLT), normal ChE (N-ChE), normal PC (N-PLT), all abnormal (A-SBM), abnormal AST/ALT (A-SLT), abnormal ChE (A-ChE), abnormal PC (A-PLT). Subjects achieving jaundice clearance (JC) and surviving with native livers (SNL) also had gamma glutamyl transpeptidase (γGTP) assessed. Redo-PE indicated for failed PE were assessed postoperatively using the same SBM/BSC protocol. Results: PE were laparoscopic (LPE; n=40) or open (OPE; n=30). Mean age/weight at PEand duration of follow-up were similar. For JC, LPE=34/40 (85.0%), OPE=22/30 (73.3%); p=0.23. For SNL, LPE=29/40 (72.5%), OPE=16/30 (53.3%); p=0.10. LPE and OPE were similar for SBM/BSC, except for a single significant increase in ALT in OPE at 6 months.Redo-PE was performed 17 to 180 days (mean 67.1 days) after primary PE. AST was significantly increased at the last pre-redo assessment 3 months after primary PE; p<0.05.After redo, AST decreased and SBM/BSC results were equivalent to non-redo subjects. Conclusion:Postoperative biochemical data for all PE cases were comparable; redo-PE would appear to be viable for restoring SBM, and AST could be valuable as a single marker of deterioration in redo cases.

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Comprehensive assessment of prognosis after laparoscopic portoenterostomy for biliary atresia

Abstract: Although JC was better after LPE, 3BM were better after OPE. Further follow-up will prove the comprehensive prognostic value of 3BM.

Cited by 19 publications

References 17 publications

Laparoscopic versus Open Pediatric Surgery: Three Decades of Comparative Studies

Laparoscopic versus Open Pediatric Surgery: Three Decades of Comparative Studies

Modern Approaches to the Surgical Treatment of Biliary Atresia

Biochemical Evaluation of Laparoscopic Portoenterostomy for Treating Biliary Atresia and Redo for Failed Portoenterostomy

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