PROSPECTIVE CLINICAL STUDY ABOUT THE PROGNOSIS IN EXTRAHEPATIC BILIARY ATRESIA PATIENTS FOLLOWING KASAI’S PORTOENTEROSTOMY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 51
Abstract
PURPOSE To evaluate the prognosis in extrahepatic biliary atresia patients following Kasai’s portoenterostomy. MATERIALS AND METHODS This prospective study of 64 Extrahepatic Biliary Atresia cases was conducted over 5 yrs. at Niloufer Hospital from March 2008 to March 2013. Of these, 43 patients underwent Kasai’s procedure. Patients were analysed into 3 groups based on surgical outcome. A. Satisfactory response with Sr. Bilirubin <2 mg% with isotope scan showing complete excretion of tracer; B. Partial response with Sr. Bilirubin >2 mg%; C. Therapeutic failure same as preoperative status. RESULTS 9 (21%) of the 43 cases following Kasai’s portoenterostomy had satisfactory response without periportal fibrosis on liver biopsy. Of these 4 satisfactory responders presented within 2 months of age. The partial responders and therapeutic failure cases (79%) had cirrhosis. Changes in postoperative bilirubin level is a good indicator of bile drainage. CONCLUSIONS The study revealed that early surgical intervention indicated by the absence of periportal fibrosis is a good prognostic indicator. The present series also emphasizes the need for regular followup, at least for a period of 5 years following portoenterostomy. By this, patient can be prognosticated and thereby refer the partial and therapeutic failure patients for early liver transplant program.
Authors and Affiliations
Nagarjuna , Gulam Irfan, Ramesh Kota, Srirampur , Hari Sharab
Keywords
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- EP ID EP128589
- DOI 10.14260/jemds/2016/771
- Views 92
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