scholarly journals A New Era of Laparoscopic Revision of Kasai Portoenterostomy for the Treatment of Biliary Atresia

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Naruhiko Murase ◽  
Hiroo Uchida ◽  
Yasuyuki Ono ◽  
Takahisa Tainaka ◽  
Kazuki Yokota ◽  
...  
Keyword(s):  
Blood Loss ◽  
Biliary Atresia ◽  
Surgical Outcomes ◽  
Biliary Drainage ◽  
Bile Flow ◽  
Operation Time ◽  
Major Complication ◽  
Kasai Portoenterostomy ◽  
New Era ◽  
Native Liver

Purpose.Kasai portoenterostomy is the standard therapy for biliary atresia (BA). If Kasai is unsuccessful, there is controversy over whether revision of Kasai restores adequate biliary drainage. Although there are several reports of laparoscopic Kasai (Lap-Kasai), none has described laparoscopic revision (Lap-revision). The purposes of this study were to evaluate the feasibility and efficacy of Lap-revision.Methods.65 patients underwent open Kasai between November 2001 and November 2013, and 12 patients underwent Lap-Kasai between December 2013 to January 2015. The indications for revision included bile flow cessation and recurrent cholangitis. Clinical data were compared between open and laparoscopic revisions of Kasai.Results.Open revision of Kasai was performed in 20 patients after open Kasai, and Lap-revision was performed in 4 patients after Lap-Kasai. Lap-revision was completed without conversion or major complication in any patient. The bilirubin level was normalized by Lap-revision in all four patients, and three of them were alive with their native liver. Open and laparoscopic revisions of Kasai were comparable in terms of the operation time, blood loss, and surgical outcomes.Conclusion.Lap-revision is a feasible and effective method for the treatment of BA and might herald a new era for the treatment of this disease.

scholarly journals Predictors of Successful Kasai Portoenterostomy and Survival with Native Liver at 2 Years in Infants with Biliary Atresia

2019 ◽  
Vol 9 (4) ◽  
pp. 453-459 ◽  
Author(s):  
Ruchika Kumar ◽  
Bikrant B. Lal ◽  
Vikrant Sood ◽  
Rajeev Khanna ◽  
Senthil Kumar ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Kasai Portoenterostomy ◽  
Native Liver ◽  
Survival With Native Liver

Impact of an Ultrasonically Activated Device in Robot-Assisted Distal Gastrectomy

2017 ◽  
Vol 12 (6) ◽  
pp. 453-458
Author(s):  
Makoto Hikage ◽  
Masanori Tokunaga ◽  
Rie Makuuchi ◽  
Yutaka Tanizawa ◽  
Etsuro Bando ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Surgical Outcomes ◽  
Distal Gastrectomy ◽  
Operation Time ◽  
Patient Characteristics ◽  
Clinicopathological Characteristics ◽  
Robot Assisted ◽  
Estimated Blood Loss ◽  
Device Use

Objective Robot-assisted gastrectomy is increasingly used for the treatment of gastric cancer, although it remains a time-consuming procedure. An ultrasonically activated device might be useful to shorten operation times. This study therefore assessed the effect of ultrasonically activated device use on procedural times and on other early surgical outcomes. Methods Consecutive patients (N = 42) who underwent robot-assisted distal gastrectomy for gastric cancer were included. Clinicopathological characteristics and early surgical outcomes were compared between robotic-assisted gastrectomy procedures using an ultrasonically activated device (U group, n = 21) and those without it (NU group, n = 21). Results There were no significant differences in patient characteristics between the groups; however, the median operation time was significantly less in the U group than in the NU group (291 vs 351 minutes, P = 0.006). In detail, the median duration of console time until dividing the duodenum was less in the U group (70 vs 102 minutes, P < 0.001). Estimated blood loss, incidence of postoperative morbidity, and duration of postoperative hospital stay were not different between the groups. Conclusions An ultrasonically activated device reduced the operation time of robot-assisted gastrectomy without increasing blood loss and morbidity.

scholarly journals Preoperative Serum IL-12p40 Is a Potential Predictor of Kasai Portoenterostomy Outcome in Infants with Biliary Atresia

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Shaimaa Samy Goda ◽  
Mohamed Ahmed Khedr ◽  
Soha Zaki Elshenawy ◽  
Tarek Mohamed Ibrahim ◽  
Hanaa Ahmed El-Araby ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Surgical Outcomes ◽  
Standard Of Care ◽  
Successful Outcome ◽  
Kasai Portoenterostomy ◽  
Successful Operation ◽  
Potential Predictor ◽  
Preoperative Serum ◽  
Standard Of Care Treatment ◽  
And Control

The standard-of-care treatment for biliary atresia (BA) is surgical restoration of bile flow by Kasai portoenterostomy. We aimed to study serum interleukin- (IL-) 12p40, a natural antagonist for the proinflammatory IL-12p70, and its relation to surgical outcomes of BA. The study included 75 infants with neonatal cholestasis: BA group (n=25), non-BA cholestasis group (n=30), and neglected BA group (n=20), in addition to thirty healthy neonates serving as controls. IL-12p40 was measured by ELISA in all individuals and a second assessment was performed 3 months postoperatively in the BA group. The surgical outcomes were classified as successful (bilirubin ≤ 2 mg/dl) or failed (bilirubin > 2 mg/dl). IL-12p40 was higher in BA compared to that in the non-BA and control groups (P values were 0.036 and <0.0001, resp.) but comparable to that in the neglected BA group. Preoperative IL-12p40 levels in BA patients were significantly higher in successful Kasai compared with failed Kasai and a cutoff level of 547.47 pg/ml could predict the successful outcome with 87.5% sensitivity and 82.4% specificity. Three-month postoperative IL-12p40 tended to decrease in both the successful and failed groups. In conclusion, preoperative serum IL-12p40 is a potential predictor of Kasai outcome. Serial postoperative measurements may anticipate the failure of an initially successful operation, hence the need for liver transplantation.

Ten-Year Native Liver Survival Rate After Laparoscopic and Open Kasai Portoenterostomy for Biliary Atresia

2019 ◽  
Vol 29 (1) ◽  
pp. 121-125 ◽  
Author(s):  
Kin Wai Edwin Chan ◽  
Kim Hung Lee ◽  
Hei Yi Vicky Wong ◽  
Siu Yan Bess Tsui ◽  
Jennifer Wai Cheung Mou ◽  
...  
Keyword(s):  
Survival Rate ◽  
Biliary Atresia ◽  
Kasai Portoenterostomy ◽  
Native Liver ◽  
Native Liver Survival

scholarly journals The Fecal Microbiome in Infants With Biliary Atresia Associates With Bile Flow After Kasai Portoenterostomy

2020 ◽  
Vol 70 (6) ◽  
pp. 789-795 ◽  
Author(s):  
Mary Elizabeth M. Tessier ◽  
Laurel Cavallo ◽  
Jennifer Yeh ◽  
Sanjiv Harpavat ◽  
Kristi L. Hoffman ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Bile Flow ◽  
Kasai Portoenterostomy ◽  
Fecal Microbiome

37. Predictors of successful kasai-portoenterostomy and survival with native liver at 2 years in infants with biliary atresia

2018 ◽  
Vol 8 ◽  
pp. S119
Author(s):  
Ruchika Kumar ◽  
Bikrant Bihari Lal ◽  
Vikrant Sood ◽  
Rajeev Khanna ◽  
Senthil Kumar ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Kasai Portoenterostomy ◽  
Native Liver ◽  
Survival With Native Liver

Survival With the Native Liver After Laparoscopic Versus Conventional Kasai Portoenterostomy in Infants With Biliary Atresia

2011 ◽  
Vol 253 (4) ◽  
pp. 826-830 ◽  
Author(s):  
Benno M. Ure ◽  
Joachim F. Kuebler ◽  
Nagoud Schukfeh ◽  
Carsten Engelmann ◽  
Jens Dingemann ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Kasai Portoenterostomy ◽  
Native Liver

Laparoscopic versus open Kasai portoenterostomy in infant with biliary atresia: a retrospective review on the 5-year native liver survival

2012 ◽  
Vol 28 (11) ◽  
pp. 1109-1113 ◽  
Author(s):  
Kin Wai E. Chan ◽  
Kim Hung Lee ◽  
Siu Yan B. Tsui ◽  
Yuen Shan Wong ◽  
Kit Yi K. Pang ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Retrospective Review ◽  
Kasai Portoenterostomy ◽  
Native Liver ◽  
Native Liver Survival

scholarly journals Association of rs17095355 Polymorphism and Extrahepatic Biliary Atresia among Filipinos

2017 ◽  
Vol 51 (3) ◽  
Author(s):  
Fresthel Monica M. Climacosa ◽  
Germana Emerita V. Gregorio ◽  
Catherine Lynn T. Silao
Keyword(s):  
Biliary Atresia ◽  
Direct Sequencing ◽  
Kasai Portoenterostomy ◽  
The Third ◽  
Extrahepatic Biliary Atresia ◽  
Post Surgery ◽  
Significant Difference ◽  
Native Liver ◽  
Filipino Children ◽  
Genetic Mechanisms

Background. Extrahepatic biliary atresia (EHBA) causes a rare obstructive cholestasis in infants. Kasai portoenterostomy if done before the third month of life may relieve obstruction. Genetic predisposition has been implicated in EHBA etiopathogenesis with rs17095355 polymorphism having the strongest association. We determined the association between rs17095355 and EHBA susceptibility of Filipino children, and described the outcome in each genotype among timely operated patients. Methods. Thirty-four histologically diagnosed EHBA patients and thirty-three age- and sex-matched controls were recruited. Genomic DNA was extracted from peripheral blood and subjected to PCR and direct sequencing. Success of surgery among patients operated before 90 days of life was assessed by jaundice clearance six months post-surgery and native liver survival two and five years post-surgery. Results. There was no significant difference among individuals carrying T and C alleles in developing EHBA (OR:1.36; 95%CI:0.65–2.86). Jaundice persisted post-operatively in 75%, 33% and 27% of Kasai-operated homozygous T (T/T), homozygous C (C/C) and heterozygous (C/T) patients, respectively. Fifty percent of Kasai-operated C/C and C/T patients retained their native liver whereas all Kasai-operated T/T patients required liver transplantation two years post-surgery. Conclusion. There is insufficient evidence to associate rs17095355 in EHBA development among Filipinos. Further investigation is warranted to elucidate genetic mechanisms in EHBA etiopathogenesis.

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