Duration from the first pale stool to portoenterostomy is prognostic in biliary atresia. Comparison with age at portoenterostomy

Objective: Three criteria (age at first pale stool, age at portoenterostomy, and duration from the first pale stool to portoenterostomy) were assessed for prognostic value in biliary atresia. Methods: The medical records of 116 consecutive biliary atresia patients treated by portoenterostomy after liver transplantation became available in Japan in 1989 were identified and data from 96 were analyzed retrospectively for this study. The impact of each criterion on clearance of jaundice to normal levels (total serum bilirubin <= 1.2 mg/dL) and survival with the native liver as indicators of outcome were compared according to time (<= 30 days, 31-60 days, and >= 61 days). Results: Age at first pale stool was <= 30 days in 53, 31-60 days in 26, >= 61 days in 17; age at portoenterostomy was <= 30 days in 7, 31-60 days in 35, >= 61 days in 54, and duration preportoenterostomy was <= 30 days in 50, 31-60 days in 36, >= 61 days in 10. Survival with the native liver was not significantly influenced by age at first pale stool or age at portoenterostomy, but prolonged duration (>= 61 days) reduced survival with the native liver significantly (p = 0.003). Clearance of jaundice to normal levels was not affected by any criterion at any time. (C) 2020 Elsevier Masson SAS. All rights reserved.