Vol. 3, Issue 1, Part B (2019)

Introduction and Background: Untreated biliary atresia, an obliterative cholangiopathy that begins in infancy and progresses to cirrhosis and liver fibrosis, can be fatal. The major surgical procedure for reestablishing bile flow and postponing liver transplantation is the Kasai portoenterostomy. The long-term results of the Kasai surgery, meanwhile, can be quite different. Aiming to assess survival, biochemical, and clinical outcomes in the long run, this study followed children who had the Kasai surgery for biliary atresia.

Materials and Methods: In this cohort study that looked back at This study was conducted at the Department of Paediatrics, Tagore Medical College and Hospital, Chennai, Tamil Nadu, India from February 2018 to January 2019, 60 kids with biliary atresia who had the Kasai surgery done at a tertiary pediatric surgical center were included. At least five years after surgery, patients were monitored. The following variables were recorded: age at surgery, frequency of cholangitis, clearing of jaundice, growth parameters, complications, and native liver survival; liver function tests; and health of the patient's liver.

Results: After 6 months following surgery, 33.3% of the 60 children (38 out of 60) no longer had jaundice. Surgery was performed at a median age of 58 days. Out of the total number of patients followed up, 25 (41.7%) experienced recurrent cholangitis, and 14 (23.3%) needed a liver transplant because their livers were failing. The native liver survival rate was 66.7% after 5 years and 53.3% after 10 years after Kasai surgical procedure. The results were noticeably better (p<0.05) for children who had the Kasai operation performed before they were sixty days old. Seventy percent of animals with native livers survived with appropriate growth parameters.

Conclusion: Children with biliary atresia still have a possibility for native liver survival after the Kasai surgery, particularly if it's done early on. Regardless, many patients experience sequelae such cholangitis and may need a liver transplant in the long run. The key to maximizing results is prompt referral for transplantation and lifelong follow-up.