Results of Kasai Operation for Biliary Atresia in a Single Institution

Abstract

Purpose : We reviewed our experience of the Kasai operation for biliary atresia (BA) to assess the surgical outcomes.
Methods : From May 1993 to May 2013, 58 patients with BA underwent the Kasai operation at our institution. They were divided into two groups, group 1 representing the early period (from 1993 to 2000 ; n＝24) and group 2 the late period (from 2001 to 2013 ; n＝34), based on the difference in postoperative management protocols. Medical records were retrospectively analyzed.
Results : There was no statistically significant difference between the two groups in age, body weight, and the serum bilirubin level at operation. The operation time in group 2 was significantly longer than in group 1. The postoperative jaundice-free ratio (PJFR) in group 2 was significantly higher than in group 1 (79.4% vs. 29.2%). There was no significant difference in the PJFR between patients who underwent the Kasai operation after 61 days or more and those before 61 days. The overall 5-year survival rate of the native liver (SRNL) was 37.8%. The SRNL in group 2 was higher than in group 1 (50.0% vs. 26.1%).
Conclusions : Improvement in PJFR in group 2 was probably related to changes in postoperative management protocols. Based on our data, early diagnosis and early Kasai operation does not necessarily improve postoperative outcomes such as SRNL or PJFR in patients with BA. The 5-year SRNL in group 2 was higher than in group 1, which might be a result of improvement in PJFR.