دورية أكاديمية
Cholestasis after Kasai operation predicts portal hypertension in native liver survivors of biliary atresia: a multicenter study.
| العنوان: | Cholestasis after Kasai operation predicts portal hypertension in native liver survivors of biliary atresia: a multicenter study. |
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| المؤلفون: | Chung PHY; Division of Paediatric Surgery, Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, HKSAR, People's Republic of China., Harumatsu T; Department of Pediatric Surgery, Kagoshima University, Kagoshima, Japan., Nakagawa Y; Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Tsuboi K; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan., Chan EKW; Division of Pediatric Surgery and Pediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, HKSAR, People's Republic of China., Leung MWY; Department of Surgery, Hong Kong Children's Hospital, Hong Kong, HKSAR, People's Republic of China., Yeung F; Division of Paediatric Surgery, Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, HKSAR, People's Republic of China., Muto M; Department of Pediatric Surgery, Kagoshima University, Kagoshima, Japan., Kawano T; Department of Pediatric Surgery, Kagoshima University, Kagoshima, Japan., Amano H; Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Shirota C; Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Nakamura H; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan., Koga H; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan., Miyano G; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan., Yamataka A; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan., Ieiri S; Department of Pediatric Surgery, Kagoshima University, Kagoshima, Japan., Uchida H; Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Wong KKY; Division of Paediatric Surgery, Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, HKSAR, People's Republic of China. kkywong@hku.hk. |
| المصدر: | Pediatric surgery international [Pediatr Surg Int] 2024 Jul 17; Vol. 40 (1), pp. 196. Date of Electronic Publication: 2024 Jul 17. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 8609169 Publication Model: Electronic Cited Medium: Internet ISSN: 1437-9813 (Electronic) Linking ISSN: 01790358 NLM ISO Abbreviation: Pediatr Surg Int Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Berlin : Springer International, c1986- |
| مواضيع طبية MeSH: | Biliary Atresia*/surgery , Biliary Atresia*/complications , Portoenterostomy, Hepatic*/methods , Hypertension, Portal*/etiology , Cholestasis*/etiology, Humans ; Male ; Female ; Infant ; Postoperative Complications/epidemiology ; Prospective Studies ; Follow-Up Studies ; Survivors/statistics & numerical data ; Infant, Newborn ; Child, Preschool |
| مستخلص: | Purpose: This study evaluated portal hypertension (PHT) and its predictors among native liver survivors (NLS) of biliary atresia (BA) after Kasai portoenterostomy (KPE). Methods: This was a multicenter study using prospectively collected data. The subjects were patients who remained transplant-free for 5 years after KPE. Their status of PHT was evaluated and variables that predicted PHT were determined by regression analysis and receiver operating characteristic (ROC) curve. Results: Six centers from East Asia participated in this study and 320 subjects with KPE between 1980 to 2018 were analyzed. The mean follow-up period was 10.6 ± 6.2 years. At the 5th year after KPE, PHT was found in 37.8% of the subjects (n = 121). Patients with KPE done before day 41 of life had the lowest percentage of PHT compared to operation at older age. At 12 months after KPE, PHT + ve subjects had a higher bilirubin level (27.1 ± 11.7 vs 12.3 ± 7.9 µmol/L, p = 0.000) and persistent jaundice conferred a higher risk for PHT (OR = 12.9 [9.2-15.4], p = 0.000). ROC analysis demonstrated that a bilirubin level above 38 µmol/L at 12 months after KPE predicted PHT development (sensitivity: 78%, specificity: 60%, AUROC: 0.75). Conclusions: In BA, early KPE protects against the development of PHT among NLSs. Patients with persistent cholestasis at one year after KPE are at a higher risk of this complication. They should receive a more vigilant follow-up. Level of Evidence: Level III. (© 2024. The Author(s).) |
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| فهرسة مساهمة: | Keywords: Biliary atresia; Cholestasis; Hypersplenism; Kasai portoenterostomy; Portal hypertension |
| تواريخ الأحداث: | Date Created: 20240717 Date Completed: 20240717 Latest Revision: 20240720 |
| رمز التحديث: | 20240720 |
| مُعرف محوري في PubMed: | PMC11254997 |
| DOI: | 10.1007/s00383-024-05775-0 |
| PMID: | 39017953 |
| قاعدة البيانات: | MEDLINE |
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