title: Comprehensive assessment of prognosis after laparoscopic portoenterostomy for biliary atresia.
abstract: OBJECTIVE
  Total bilirubin (T-bil) is used universally for monitoring post-portoenterostomy (PE) biliary atresia (BA) patients although other biochemical markers [BM; AST/ALT and platelet count (PC)] are also prognostic. We compared open PE (OPE) with laparoscopic PE (LPE) using T-bil, AST/ALT, and PC (3BM) as more comprehensive indicators of postoperative clinical status.
  
  
  METHODS
  Subjects were 31 PE cases (LPE: n = 17; OPE: n = 14). BA classification was type III (n = 16), type II (n = 1) in LPE and type III (n = 12), type I (n = 1), type II (n = 1) in OPE.
  
  
  RESULTS
  Mean ages and weights at PE were similar: 65.5 days, 4.4 kg (LPE) versus 69.3 days, 4.1 kg (OPE); and mean follow-up was 2.5 years for both LPE and OPE. Jaundice clearance (T-bil ≤1.2 mg/dL) was achieved in 16/17 (94.1 %) after LPE versus 10/14 (71.4 %) after OPE (p = NS), but 3BM were closer to normal after OPE. At the time of review, 13/17 LPE cases (76.5 %) were alive with native livers and 4/17 had received LTx (23.5 %) and 10/14 OPE cases (71.4 %) were alive with native livers and 4/14 had received LTx (28.6 %).
  
  
  CONCLUSIONS
  Although JC was better after LPE, 3BM were better after OPE. Further follow-up will prove the comprehensive prognostic value of 3BM.
authors.affiliation: Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Koga
authors.affiliation: Department of Pediatric Surgery, Hospital Regional de Alta Especialidad Materno Infantil, Monterrey, Mexico.
authors.forename: Joel
authors.initials: J
authors.lastname: Cazares
authors.affiliation: Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Tadaharu
authors.initials: T
authors.lastname: Okazaki
authors.affiliation: Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Lane
authors.affiliation: Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Miyano
authors.affiliation: Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Okawada
authors.affiliation: Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Doi
authors.affiliation: Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Urao
authors.affiliation: Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan. yama@juntendo.ac.jp.|Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. yama@juntendo.ac.jp.
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Yamataka
mesh_terms: D001656:Biliary Atresia / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D011171:Portoenterostomy, Hepatic; D011183:Postoperative Complications / Q000097:blood; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: Biliary atresia; Biochemistry; Laparoscopy; Liver function