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. 2013:2013:902431.
doi: 10.1155/2013/902431. Epub 2013 Nov 24.

Improved outcome of biliary atresia with postoperative high-dose steroid

Rui Dong  1 , Zai Song  1 , Gong Chen  1 , Shan Zheng  1 , Xian-Min Xiao  1
Affiliations

Improved outcome of biliary atresia with postoperative high-dose steroid

Rui Dong et al. Gastroenterol Res Pract. 2013.

Abstract

Objective. The dosage, duration, and the benefits of high-dose steroid treatment and outcome in biliary atresia (BA) remain controversial. In this study, we evaluated the impact of high-dose steroid therapy on the outcome of BA after the Kasai procedure. Methods. Intravenous prednisolone administration was started 1 week after surgery, followed by 8 to 12 weeks of oral prednisolone. Total bilirubin (TB) levels (3, 6, and 12 months after surgery), early onset of cholangitis, and two-year native liver survival were evaluated. Results. 53.4%, 56.9%, and 58.1% of the patients in the high-dose steroid group were jaundice-free 3, 6, and 12 months after surgery, respectively; these values were significantly higher than the 38.7%, 39.4%, and 43.3% of the low-dose steroid group. One year after surgery, the incidence of cholangitis in the high-dose group (32.0%) was lower than that in the low-dose group (48.0%). Infants with native liver in the high-dose group had a better two-year survival compared to those in the low-dose steroid group (53.7% versus 42.6%). Conclusions. The high-dose steroid protocol can reduce the incidence of cholangitis, increase the jaundice-free rate, and improve two-year survival with native liver after the Kasai operation.

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Figures

Figure 1
Figure 1
A flow chart of the patient groups and treatments.
See this image and copyright information in PMC

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