Journals / Turkish Journal of Gastroenterology / 2019 / Cilt: 30 - Sayı: 5

Revisiting long-term prognostic factors of biliary atresia: A 20-year experience with 81 patients from a single center

Pages
467–474
DOI
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Background/Aims: The present study aimed at investigating the long-term outcomes and prognostic factors of patients with biliaryatresia (BA) diagnosed and followed at a single center.Materials and Methods: Patients with BA treated during 1994-2014 at a large-volume pediatric tertiary referral center were reviewedretrospectively with regard to demographic, clinical, laboratory, and diagnostic characteristics for identifying the prognostic factors andlong-term clinical outcomes.Results: Overall, 81 patients (49 males, 32 females) were included.

📌 3 Key Takeaways

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Objective & Hypothesis:Background/Aims: The present study aimed at investigating the long-term outcomes and prognostic factors of patients with biliaryatresia (BA) diagnosed and followed at a single center.Materials and Methods: Patients with BA treated during 1994-2014 at a large-volume pediatric tertiary referral center were reviewedretrospectively with regard to demographic, clinical, laboratory, and diagnostic characteristics for identifying the prognostic factors andlong-term clinical outcomes.Results: Overall, 81 patients (49 males, 32 females) were included.
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Key Findings & Data:Mean age at diagnosis was 73.1±4.7 (median: 64) days.
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Conclusion & Impact:Therefore, timely diagnosis and early referral to experienced surgical centers are crucial for optimal management and favorable long-termresults in BA.
🔬Design:Review & Systematic Survey
📍Scope:2014 Verileri
⚙️Variables:Domain Parameters

Özet

Background/Aims: The present study aimed at investigating the long-term outcomes and prognostic factors of patients with biliaryatresia (BA) diagnosed and followed at a single center.Materials and Methods: Patients with BA treated during 1994-2014 at a large-volume pediatric tertiary referral center were reviewedretrospectively with regard to demographic, clinical, laboratory, and diagnostic characteristics for identifying the prognostic factors andlong-term clinical outcomes.Results: Overall, 81 patients (49 males, 32 females) were included. Mean age at diagnosis was 73.1±4.7 (median: 64) days. Of the patients included, 78 patients (96%) underwent a portoenterostomy procedure. Mean age at operation was 76.8±4.7 (median: 72) days.The surgical success rate was 64.8%. A younger age (either at diagnosis or surgery) was the only determinant of surgical success. The2-, 5-, and 10-year overall survival (OS) rates, including all patients with or without liver transplantation, were 75%, 73%, and 71% respectively, whereas the 2-, 5-, and 10-year survival rates with native liver (SNL) were 69%, 61%, and 57%, respectively. Mean follow-upduration was 9.4±7.5 years. Successful surgery, presence of fibrosis and/or cirrhosis on the liver pathology, and prothrombin time [international normalized ratio (INR)] at presentation were independent prognostic factors for both OS and SNL.Conclusion: A younger age at diagnosis is strongly associated with surgical success in BA. Surgical success, the prothrombin time (INR)at presentation, and liver pathology are independent prognostic factors affecting the long-term outcomes in patients with BA. Therefore, timely diagnosis and early referral to experienced surgical centers are crucial for optimal management and favorable long-termresults in BA.

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Cite This Article

HANALİOĞLU, D., ÖZEN, H., KARHAN, A., GÜMÜŞ, E., DEMİR, H., TEMİZEL, İ. N. S., EKİNCİ, S., KARNAK, İ., ÇİFTÇİ, A. Ö., TANYEL, F. C., YÜCE, A. (2019). Revisiting long-term prognostic factors of biliary atresia: A 20-year experience with 81 patients from a single center. Turkish Journal of Gastroenterology, Cilt: 30 - Sayı: 5, 467–474. https://ajindex.com/articles/408754

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References (14)

  1. Jimenez-Rivera C, Jolin-Dahel KS, Fortinsky KJ, Gozdyra P, Benchimol EI. International incidence and outcomes of biliary atresia. J Pediatr Gastroenterol Nutr 2013
  2. [CrossRef] 2. Chardot C, Serinet MO. Prognosis of biliary atresia: what can be further improved? J Pediatr 2006
  3. [CrossRef] 3. Wildhaber BE. Biliary atresia: 50 years after the first kasai. ISRN Surg 2012
  4. 132089. [CrossRef] 4. Lopez RN, Ooi CY, Krishnan U. Early and Peri-operative Prognostic Indicators in Infants Undergoing Hepatic Portoenterostomy for Biliary Atresia: a Review. Curr Gastroenterol Rep 2017
  5. [CrossRef] 5. Serinet MO, Broué P, Jacquemin E, et al. Management of patients with biliary atresia in France: results of a decentralized policy 1986- 2002. Hepatology 2006
  6. [CrossRef] 6. Wildhaber BE, Majno P, Mayr J, et al. Biliary atresia: Swiss national study, 1994-2004. J Pediatr Gastroenterol Nutr 2008
  7. [CrossRef] 7. Subramaniam R, Doig CM, Bowen J, Bruce J. Initial response to portoenterostomy determines long-term outcome in patients with biliary atresia. J Pediatr Surg 2000
  8. [CrossRef] 8. Chittmittrapap S, Chandrakamol B, Poovorawan Y, Suwangool P. Factors influencing outcome after hepatic portoenterostomy for biliary atresia: a logistic regression analysis. J Med Assoc Thai 2005
  9. Altman RP, Lilly JR, Greenfeld J, Weinberg A, van Leeuwen K, Flanigan L. A multivariable risk factor analysis of the portoenterostomy (Kasai) procedure for biliary atresia: twenty-five years of experience from two centers. Ann Surg 1997
  10. [CrossRef] 10. Pakarinen MP, Johansen LS, Svensson JF, et al. Nordic Pediatric Surgery Study Consortium. Outcomes of biliary atresia in the Nordic countries - a multicenter study of 158 patients during 2005-2016. J Pediatr Surg 2018
  11. [CrossRef] 11. Sangkhathat S, Patrapinyokul S, Tadtayathikom K, Osatakul S. Peri-operative factors predicting the outcome of hepatic porto-enterostomy in infants with biliary atresia. J Med Assoc Thai 2003
  12. Schoen BT, Lee H, Sullivan K, Ricketts RR. The Kasai portoenterostomy: when is it too late? J Pediatr Surg 2001
  13. [CrossRef] 13. Wildhaber BE, Coran AG, Drongowski RA, et al. The Kasai portoenterostomy for biliary atresia: A review of a 27-year experience with 81 patients. J Pediatr Surg 2003
  14. [CrossRef] 14. Witt M, van Wessel DBE, de Kleine RHJ, Bruggink JLM, Hulscher JBF, Verkade HJ. NeSB