Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 17;66(2):E56-E60.

Prognostic Factors for Survival of Patients with Biliary Atresia Following Kasai Surgery

Shiefa Annisa Qisthi  1 , Daniel Simada Pandapotan Saragih  1 , David Wijaya Sutowo  1 , Dian Nirmala Sirait  1 , Priscillia Imelda  1 , Sagita Mega Sekar Kencana  1 , Akhmad Makhmudi  1 , Gunadi  1
Affiliations

Prognostic Factors for Survival of Patients with Biliary Atresia Following Kasai Surgery

Shiefa Annisa Qisthi et al. Kobe J Med Sci. .

Abstract

Biliary atresia (BA) is a progressive obstruction and fibro-obliteration of the extrahepatic and intrahepatic biliary tract that causes cholestatic jaundice in infants, resulting in biliary cirrhosis and even death in the first year of life if the Kasai procedure is not performed at an earlier age. There are many prognostic factors that could affect the survival of patients with BA after Kasai surgery, however results still show some conflicting findings. A retrospective study was conducted using medical records of patients with BA who underwent Kasai surgery at Dr. Sardjito Hospital, Yogyakarta, Indonesia from June 2012 to April 2018. Twenty-nine BA patients were involved in our study, with 16 males and 13 females. Log-rank analysis showed a significant association between survival rate of BA patients with albumin level 1 month and 3 months after Kasai surgery, with p-values of 0.043 and 0.016, respectively. Interestingly, multivariate analysis revealed that cholangitis tended to have an association with BA patients' survival (p=0.09). In conclusion, the BA patients' survival might be affected by the presence of cholangitis after Kasai surgery. Further multicenter studies with a larger sample size are important to verify our results.

Keywords: Biliary Atresia; Kasai Surgery; Prognostic Factor; Survival.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Kaplan-Meier analysis for association between prognostic factors: A) Gender; B) Age at Kasai surgery; C) Albumin level at 1 month after surgery; D) Albumin level at 3 months after surgery; E) Total bilirubin level at 1 month after surgery; F) Total bilirubin level at 3 months after surgery; G) Cholangitis; H) Portal hypertension; I) Esophageal varices; and BA patients’ survival. Log rank test showed that albumin levels 1 month and 3 months after surgery had a significant association with the survival of BA patients after Kasai surgery, with p-value of 0.043 and 0.016, respectively.
See this image and copyright information in PMC

References

    1. Wildhaber BE. Biliary Atresia: 50 years after the first Kasai. ISRN Surg. 2012 Article ID 132089. - PMC - PubMed
    1. Peterson C. Pathogenesis and treatment opportunities for biliary atresia. Clin Liver Dis. 2006;10(1):73–88. - PubMed
    1. Shneider BL, Brown MB, Haber B, Whitington PF, Schwartz K, Squires R, Bezerra J, Shepherd R, Rosenthal P, Hoofnage JH, Sokol RJ. A multicenter study of the outcome of biliary atresia in the United States, 1997 to 2000. J Pediatr. 2006;148(4):467–74. - PubMed
    1. Gunadi Gunawan TA, Widiyanto G, Yuanita A, Mulyani NS, Makhmudi A. Liver transplant score for prediction of biliary atresia patients’ survival following Kasai procedure. BMC Res Notes. 2018;11:381. - PMC - PubMed
    1. Ağın M, Tümgör G, Alkan M, Ȫzden Ȫ, Satar M, Tuncer R. Clues to the diagnosis of biliary atresia in neonatal cholestasis. Turk J Gastroenterol. 2016;27:37–41. - PubMed