2001 Volume 37 Issue 5 Pages 795-799
Purpose : A retrospective review of 54 patients with biliary atresia experienced from 1986 through 1998 was made to determine the effectiveness of consolidated corticosteroid therapy (CST) on bile drainage and clinical outcome after hepatic portoenterostomy. Methods : Patients were divided into two groups. Group I patients (1986-1990, n=14) received conventional CST (Prednisolone was started 7 days after surgery to enhance bile drainage during the first postoperative month. The initial dose was 4 mg/kg/day given daily, and the dose was reduced by half every two days. This regimen was repeated after each course was completed). Group II patients (1990-1998, n=40) received consolidated CST (the same regimen was repeated whenever the stools appeared pale even if the previous dose had not yet been discontinued). Results : A significant difference was seen in total bilirubin level at 1 month postoperatively and in the survival rate between the two groups for patients who received a total dose of from 141 to 420 mg. In Group II, none of the 9 patients survived with the native liver without developing portal hypertension (PT), while 8 of 18 Group II patients who received consolidated CST of this dose survived with the native liver without developing PT (p=0.02). Conclusion : Consolidated CST has a positive effect on both short and long-term outcome in selected patients with biliary atresia.
