Korean J Pediatr Gastroenterol Nutr.  2011 Mar;14(1):74-80. 10.5223/kjpgn.2011.14.1.74.

Tentative Proposal of Optimal Timing of Kasai Operation for Biliary Atresia Based on Fibroscan Results

• Lee HY
• Park YA
• Han SJ
• Koh H

• KMID: 1451209
• DOI: http://doi.org/10.5223/kjpgn.2011.14.1.74

Abstract

PURPOSE
Based on previous research findings, it is well-known that the timing of surgery is generally considered the most important prognostic factor for a Kasai portoenterostomy, the primary treatment for biliary atresia. This research aimed to identify the optimal timing of a Kasai portoenterostomy and to verify if the proposed optimal timing corresponds to previous studies. All patients were classified by the timing of surgery, and pre- and post-operative fibrotic changes of the liver were measured with the elasticity value from fibroscans.
METHODS
The stiffness scores of the pre- and post-operative fibroscans in 34 patients who were treated by Kasai portoenterostomy from October 2007 to September 2010 in Severance children's hospital were reviewed.
RESULTS
The earlier the patients were treated by Kasai portoenterostomy, the lower the fibroscan scores. When the patients were treated prior to the 8th week, the post-operative scores of the fibroscans were significantly better than those patients who were treated after the 8th week, and some even recovered partially. Moreover, when operated before the 8th week, the differences between each pre- and post-operative fibroscan score also showed statistical relevance (p=0.0002).
CONCLUSION
The earlier the patient was treated by Kasai portoenterostomy, the less liver fibrosis that developed, the lower the level of post-operative fibrosis, and the less the degree of fibrotic progress before and after the operation. Thus, this research proposal reconfirms once more that the 8th week is the optimal timing for a Kasai portoenterostomy.

Keyword

Biliary atresia; Liver fibrosis; Fibroscan

MeSH Terms

Biliary Atresia
Elasticity
Fibrosis
Humans
Liver
Liver Cirrhosis
Research Design

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