Impact of age at Kasai operation on short- and long-term outcomes of type III biliary atresia at a single institution

Purpose: We reevaluated the impact of age at Kasai operation on the short-and long-term outcomes of type III biliary atresia (BA). Patients and Methods: From 1953 to 2009, 242 patients with type III BA underwent Kasai operation at ages ranging between 12 and 421 days (average, 79.7 days). The relationship between age at Kasai operation and jaundice disappearance rates (JDRs), and 10-, 20-, and 30-year native liver survival rates (NLSRs) were assessed retrospectively (JDR [%] = the number of patients in whom jaundice disappeared/the number of patients in each group x 100). Results: Age at Kasai operation had a significant impact on the JDRs (P <.001). However, there was no statistical relationship between long-term NLSR of the patients in whom jaundice disappeared after Kasai operation and operative age. From the results of the cumulative NLSRs estimated by Kaplan-Meier method, each survival rate was quite dependent on the age at operation until 30 years after Kasai operation, but the difference became much smaller in the later period provided age at operation was 4 months or younger. Conclusion: The operative age as a prognostic factor might be less significant in the long-term outcome than in the short-term outcome. (C) 2010 Elsevier Inc. All rights reserved.