J Korean Assoc Pediatr Surg.  1998 Dec;4(2):125-130. 10.13029/jkaps.1998.4.2.125.

Clinical & Nutritional Assessments of Long-term Survivors of Biliary Atresia

• Chun YS
• Kim WK

• KMID: 2422199
• DOI: http://doi.org/10.13029/jkaps.1998.4.2.125

Abstract

To assess the clinical and nutritional status of long-term survivors of biliary atresia, history taking, medical record review, physical examination (height, weight, MAC, TSF), blood tests (LFT, prothrombin time, platelet count, prealbumin, calcium) and liver needle biopsy were performed in 12 patients in whom Kasai procedure were performed more than 10 years ago at Department of Pediatric Surgery in Seoul National University Hospital. None were below the 5th percentile in height and weight. TSF was above the 75th percentile in all patients and showed good subcutaneous fat deposition. MAC was above the 5th percentile in all patients. Serum prealbumin level was abnormal in 2 patients with abnormal liver function and revealed visceral protein malnutrition. Serum calcium level was decreased below normal range in 4 patients with abnormal liver function. One patient had mild ascites. Five patients had abnormal liver function and 7 patients showed clinical manifestation of portal hypertension. Liver needle biopsy was performed in 5 patients and no cirrhotic change was observed. Although some patients who have survived for more than 10 years after Kasai procedure developed protein malnutrition and vitamin deficiencies, growth and development and nutritional status were generally satisfactory. Five patients(42%) showed normal liver function and no portal hypertension. In conclusion, Kasai procedure is satisfactory as a primary treatment in biliary atresia but significant portion of long-term survivors had abnormal liver function and portal hypertension. Continuous and careful follow-up is necessary to determine when liver transplantation may be indicated.

Keyword

Biliary atresia; Kasai procedure; Nutritional and clinical status

MeSH Terms

Ascites
Avitaminosis
Biliary Atresia*
Biopsy, Needle
Calcium
Follow-Up Studies
Growth and Development
Hematologic Tests
Humans
Hypertension, Portal
Liver
Liver Transplantation
Malnutrition
Medical History Taking
Nutrition Assessment*
Nutritional Status
Physical Examination
Platelet Count
Prealbumin
Prothrombin Time
Reference Values
Seoul
Subcutaneous Fat
Survivors*
Calcium
Prealbumin