title: [Prognosis in children with biliary atresia successfully treated with Kasai's operation].
abstract: BACKGROUND
  The Kasai procedure, portoenteroanastomosis (PEA) didn't reach international spreading until the seventy's decade, making difficult to find long-term results from children with ABE successfully treated with this technique. At our institution in the last fifteen years all the therapeutics procedures for these patients can be offered, including the liver transplant.
  
  
  OBJECTIVE
  To show the evolution of our patients with ABE treated with the PEA and that survive long-term without being transplanted.
  
  
  METHODS
  The clinical course of 22 patients that survive more than 10 years after the PEA with their own liver is reviewed. The hepatic survival indexes of (success, death or transplant) are beyond the tenth year. The problems raised during the follow-up are analysed.
  
  
  RESULTS
  From 99 patients with ABE treated primarily in our center, 22 reached the 10 year-old age after the PEA without a liver transplant. In the follow-up, seven if the these finally needed the transplant. Their median age was 12.2 year-old (range: 10.5-13.8) for a progressive hepatocellular damage in 5 cases associated to syndrome hepatopulmonar in two cases. The other fifteen patients have a compensated hepatopathy. Five of them do not have hyperesplenisme and the serum bilirrubine levels are lower than 1.3 mg/dL. The medium age of these patients at the end of the follow-up was 14.8 years.
  
  
  CONCLUSIONS
  In spite of the reestablishment of the biliary flow with the PEA, few are the patients with ABE that preserve their hepatic function lapsed long periods of time. Nevertheless the prognosis of these patients is excellent.
authors.affiliation: Departamento de Cirugía, Hospital Infantil La Paz, Madrid.
authors.forename: J
authors.initials: J
authors.lastname: Murcia
authors.forename: M
authors.initials: M
authors.lastname: López Santamaría
authors.forename: M
authors.initials: M
authors.lastname: Gámez
authors.forename: L
authors.initials: L
authors.lastname: Hierro
authors.forename: E
authors.initials: E
authors.lastname: Frauca
authors.forename: C
authors.initials: C
authors.lastname: Camarena
authors.forename: A
authors.initials: A
authors.lastname: de la Vega
authors.forename: M
authors.initials: M
authors.lastname: Díaz
authors.forename: P
authors.initials: P
authors.lastname: Jara
authors.forename: J
authors.initials: J
authors.lastname: Tovar
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D001656:Biliary Atresia / Q000601:surgery*; D002648:Child; D013505:Digestive System Surgical Procedures / Q000379:methods; D004766:Enterostomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011169:Portal Vein / Q000601:surgery*; D011379:Prognosis; D012074:Remission Induction