Medium-term Outcome of Laparoscopic Kasai Portoenterostomy for Biliary Atresia With 49 Cases

Objective: The aim of this study was to evaluate the mid-term results of laparoscopic Kasai portoenterostomy (LKPE) for biliary atresia (BA) at our hospital. Methods: From May 2009 to May 2012, the charts of infants with BA who underwent LKPE were reviewed retrospectively. The clearance of jaundice (CJ) as well as 3-year, and 5-year survival with native liver (SNL) rates were analyzed and compared with those after open Kasai portoenterostomy (OKPE). Results: Forty-nine patients with BA who underwent LKPE were assigned to group A, and 40 patients with BA who underwent OKPE were assigned to group B. All patients in both groups had type III non-syndromic BA, and the LKPE and OKPE procedures were performed by 2 different surgical teams at our hospital. After median follow-up periods of 77 months in group A and 79 months in group B, the CJ and 3- and 5-year SNL rates were 61.2%, 55.1%, and 36.7% in group A, and 45.0%, 37.5%, and 25.0% in group B, respectively. The difference of CJ between group A and group B was not significant. The Kaplan-Meier method analysis showed that the difference in SNL between group A and group B was not significant either. Conclusions: LKPE for patients with BA was a technically feasible and alternative procedure to OKPE. The 3- and 5-year SNL rates after LKPE were not different compared to those after OKPE.