High-dose steroids do not improve early outcome in biliary atresia.
OBJECTIVE
Our objective was to evaluate the effects of steroids on early outcome in biliary atresia (BA).


METHODS
Patients with BA between 2001 and 2005 were reviewed. The use of steroids (4 mg/kg per day at alternate days for 1 to 3 months) has been routinely implemented since 2003. Jaundice-free status and the occurrence of cholangitis at 6 months postoperatively between patients receiving steroids and those not receiving steroids were compared.


RESULTS
Fifty-three patients with BA were studied. At 6 months postoperation, 30 patients (56.6%) were jaundice free and 24 patients (45.3%) experienced cholangitis at least once. Of the 53 patients, there were 33 patients in the steroid group and 20 patients in the nonsteroid group. The proportion of jaundice-free patients in the steroid group was higher than that in the nonsteroid group, and the proportion of patients with cholangitis in the steroid group was lower than that in the nonsteroid group. However, these discrepancies did not reach a statistically significant difference (jaundice-free status [steroid vs nonsteroid]: 20/33 [60.6%] vs 10/20 [50%], P = .57; cholangitis: 13/33 [39.4%] vs 11/20 [55%], P = .39).


CONCLUSIONS
Although the use of steroids seems to have benefits, it did not statistically improve early outcome in patients with BA.
Vejchapipat
Paisarn
P
Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand. pvejchap@yahoo.co.uk
Passakonnirin
Rojjana
R
Sookpotarom
Paiboon
P
Chittmittrapap
Soottiporn
S
Poovorawan
Yong
Y
D001656:Biliary Atresia / Q000188:drug therapy* / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000379:methods; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011182:Postoperative Care; D011239:Prednisolone / Q000008:administration & dosage*; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D011239:Prednisolone