Document Detail


Maximizing Kasai portoenterostomy in the treatment of biliary atresia: medical and surgical options.
MedLine Citation:
PMID:  23116745     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Biliary atresia (BA) remains one of the most challenging conditions in paediatric surgery. It has several possible causes, resulting in a range of different clinical scenarios. The current therapeutic approach is almost entirely surgical with an initial attempt to restore bile flow and preserve the native liver using a Kasai-type portoenterostomy. Liver transplantation (cadaveric or living donor) is usually reserved for failure or for infants presenting late with end-stage cirrhosis. The role of adjuvant medical therapy is unclear and evidence of benefit is lacking. Nonetheless, the use of post-operative steroids, prophylactic antibiotics and choleretic agents such as ursodeoxycholic acid is common. Ideally, the entire pathway should be complementary and seamless with few infants dying of end-stage liver disease or uncorrectable associated congenital malformations. Experience from high-volume centres suggests that clearance of jaundice can be achieved in 50 - 60% of infants with 10-year native liver and real survival rates of 45% and 90%, respectively.
Authors:
Mark Davenport; Andrew Grieve
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Publication Detail:
Type:  Journal Article; Review     Date:  2012-09-10
Journal Detail:
Title:  South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde     Volume:  102     ISSN:  0256-9574     ISO Abbreviation:  S. Afr. Med. J.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-02     Completed Date:  2013-01-10     Revised Date:  2014-09-12    
Medline Journal Info:
Nlm Unique ID:  0404520     Medline TA:  S Afr Med J     Country:  South Africa    
Other Details:
Languages:  eng     Pagination:  865-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Biliary Atresia / surgery*,  therapy*
Cholangitis / prevention & control
Humans
Infant
Nutritional Support
Portoenterostomy, Hepatic* / methods
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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