THE SUCCESS RATE OF KASAI PROCEDURE IN BILLIARY ATRESIA: CHARACTERISTIC BASED ON AGE AND LIVER HISTOPATHOLOGY
Hardiyanti Ari Wiranita,Titis Widowati,Nenny Sri Mulyani
Departement of Child Health, Faculty of Medicine, Public Health and Nursing, RS Dr Sardjito Universitas Gadjah Mada Yogyakarta, Indonesia
Background : Biliary atresia (BA) is an obstructive condition of the bile ducts. If remains untreated, BA can lead to liver failure and death in the first two years of life. Kasai portoenterostomy (KPE) is one therapeutic option in these patients with a success rate of 30-40%. Objective: To know the age and liver histopathology characteristic in BA patients underwent successful KPE.
Material : A study retrieving data from medical record was conducted. BA patients who were diagnosed based on intraoperative cholangiography at Dr. Sardjito Hospital in January 2015 to December 2017 were included. We classified into two groups based on the level of total bilirubin at five weeks after KPE. Group I: subjects with the successful KPE (total bilirubin serum ? 6 mg/dl). Group II: subjects with unsuccessful KPE (total bilirubin serum > 6 mg/dL). The two groups were compared regarding age at KPE and liver histology (cirrhosis and non-cirrhosis).
Results : Twenty nine children were eligible, 9 (31%) underwent successful KPE (group I) while 20 (60.8%) did not. Of nine subjects in the successful group, 89% subjects were > 60 days of age; six of nine had no liver cirrhosis (66.7%). Unsuccessful group showed nearly similar characteristics with most subjects were > 60 days of age (90%) and 50% had no liver cirrhosis.
Conclusions : No significant difference in characteristic between patients underwent successful and unsuccessful KPE. To evaluate the effect of age and liver histopathology toward success rate of KPE, further study with larger subjects is required.
Keywords: biliary atresia kasai portoenterostomy age liver histopathology
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