Partial splenic embolization decreases the serum bilirubin level in patients with hypersplenism following the Kasai procedure for biliary atresia.
BACKGROUND
Partial splenic embolization (PSE) has been used in the palliative treatment of adults and children with hypersplenism. However, there has been no previous report of its use in the treatment of patients with jaundice. The purpose of this study was to investigate the utility of PSE in the treatment of jaundice in patients with biliary atresia and hypersplenism.


METHODS
Partial splenic embolization was performed in eight patients with biliary atresia and hypersplenism that developed following the Kasai procedure. Seven of them had experienced complete resolution of jaundice postoperatively, but became icteric thereafter. Jaundice remained unchanged in the initial postoperative period in the last patient but subsequently worsened. White blood cell, platelet, and red blood cell counts, hematocrit, and hemoglobin concentrations, and serum concentrations of glutamic-oxaloacetic transaminase, glutamate pyruvate transaminase, alkaline phosphatase, lactate dehydrogenase, albumin, and total bilirubin were evaluated one month before PSE and one, two, three, six, nine, 12, 18, and 24 months after PSE.


RESULTS
The total bilirubin concentration decreased in all patients after PSE from 8.6 +/-3.6 mg/dL to 3.0 +/-1.0 mg/dL. This change was noted within three months of PSE, and correlated with an increase in the red blood cell count.


CONCLUSIONS
Partial splenic embolization is a useful method for reducing serum bilirubin concentrations in patients with hypersplenism following the Kasai procedure for biliary atresia.
Ando
H
H
Department of Surgery, Branch Hospital, Nagoya University School of Medicine, Japan.
Ito
T
T
Nagaya
M
M
D000293:Adolescent; D001656:Biliary Atresia / Q000150:complications / Q000601:surgery*; D001663:Bilirubin / Q000097:blood*; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000097:blood / Q000209:etiology / Q000628:therapy*; D008297:Male; D010166:Palliative Care; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000628:therapy; D012044:Regression Analysis; D013157:Splenic Artery
D015415:Biomarkers; D001663:Bilirubin