Impact of age at Kasai operation on short- and long-term outcomes of type III biliary atresia at a single institution.
OBJECTIVE
We reevaluated the impact of age at Kasai operation on the short- and long-term outcomes of type III biliary atresia (BA).


METHODS
From 1953 to 2009, 242 patients with type III BA underwent Kasai operation at ages ranging between 12 and 421 days (average, 79.7 days). The relationship between age at Kasai operation and jaundice disappearance rates (JDRs), and 10-, 20-, and 30-year native liver survival rates (NLSRs) were assessed retrospectively (JDR [%] = the number of patients in whom jaundice disappeared/the number of patients in each group × 100).


RESULTS
Age at Kasai operation had a significant impact on the JDRs (P < .001). However, there was no statistical relationship between long-term NLSR of the patients in whom jaundice disappeared after Kasai operation and operative age. From the results of the cumulative NLSRs estimated by Kaplan-Meier method, each survival rate was quite dependent on the age at operation until 30 years after Kasai operation, but the difference became much smaller in the later period provided age at operation was 4 months or younger.


CONCLUSIONS
The operative age as a prognostic factor might be less significant in the long-term outcome than in the short-term outcome.
Department of Pediatric Surgery, Tohoku University School of Medicine, Sedai 980-8574, Japan. mnio@ped-surg.med.tohoku.ac.jp
Masaki
M
Nio
Hideyuki
H
Sasaki
Motoshi
M
Wada
Takuro
T
Kazama
Kotaro
K
Nishi
Hiromu
H
Tanaka
D000367:Age Factors; D001656:Biliary Atresia / Q000145:classification / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D004766:Enterostomy / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D041781:Jaundice, Obstructive / Q000209:etiology / Q000601:surgery; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome