title: Short-term results of Kasai operation for biliary atresia: experience from one institution.
abstract: BACKGROUND
  The purpose of this study is to review the short-term outcome of patients with biliary atresia (BA) treated by the Kasai operation at our institution.
  
  
  METHODS
  Ninety-two BA patients treated by the Kasai operation between January 1996 and December 2002 were reviewed. The diagnosis of BA was confirmed by intraoperative cholangiography. The outcome of treatment was categorized into two groups: jaundice-free (total bilirubin < 2 mg%) and persistent jaundice (>or= 2 mg%). The outcome of Kasai operation was evaluated 1 year after surgery. Data are expressed as mean +/- SD.
  
  
  RESULTS
  Average age at the time of surgery was 90.26 +/- 36.44 days. Only 22.8% (21/92) of patients had Kasai operation before 60 days of age. Histologically, 49 patients (54.4%) had liver fibrosis at the time of surgery. Of 92 patients, 17 were not included in outcome evaluation as they were less than 1-year postsurgery. Therefore, 75 patients could be evaluated for the outcome. Thirty-eight patients (50.67%) were jaundice-free 1 year after surgery. Liver histology and age at the time of the Kasai operation did not influence early outcome. The most common complication was ascending cholangitis.
  
  
  CONCLUSIONS
  Half of our BA patients who underwent Kasai operation were jaundice-free 1 year after surgery. The lack of impact of age and liver pathology on outcome is presumably due to the briefness of the follow-up. In general, our patients underwent Kasai procedure too late. It is therefore important for us to conduct a campaign to highlight the plight of these patients and the urgency of referral for neonates with jaundice.
authors.affiliation: Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Paiboon
authors.initials: P
authors.lastname: Sookpotarom
authors.forename: Paisarn
authors.initials: P
authors.lastname: Vejchapipat
authors.forename: Soottiporn
authors.initials: S
authors.lastname: Chittmittrapap
authors.forename: Paiboon
authors.initials: P
authors.lastname: Sookpotarom
authors.forename: Paisarn
authors.initials: P
authors.lastname: Vejchapipat
authors.forename: Soottiporn
authors.initials: S
authors.lastname: Chittmittrapap
authors.forename: Voranush
authors.initials: V
authors.lastname: Chongsrisawat
authors.forename: Bidhya
authors.initials: B
authors.lastname: Chandrakamol
authors.forename: Yong
authors.initials: Y
authors.lastname: Poovorawan
mesh_terms: D000713:Anastomosis, Roux-en-Y; D001656:Biliary Atresia / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007582:Jejunostomy; D008297:Male; D011171:Portoenterostomy, Hepatic; D012189:Retrospective Studies; D016896:Treatment Outcome