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Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid

Objective. The dosage, duration, and the benefits of high-dose steroid treatment and outcome in biliary atresia (BA) remain controversial. In this study, we evaluated the impact of high-dose steroid therapy on the outcome of BA after the Kasai procedure. Methods. Intravenous prednisolone administrat...

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Autores principales: Dong, Rui, Song, Zai, Chen, Gong, Zheng, Shan, Xiao, Xian-min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857902/
https://www.ncbi.nlm.nih.gov/pubmed/24348545
http://dx.doi.org/10.1155/2013/902431
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author Dong, Rui
Song, Zai
Chen, Gong
Zheng, Shan
Xiao, Xian-min
author_facet Dong, Rui
Song, Zai
Chen, Gong
Zheng, Shan
Xiao, Xian-min
author_sort Dong, Rui
collection PubMed
description Objective. The dosage, duration, and the benefits of high-dose steroid treatment and outcome in biliary atresia (BA) remain controversial. In this study, we evaluated the impact of high-dose steroid therapy on the outcome of BA after the Kasai procedure. Methods. Intravenous prednisolone administration was started 1 week after surgery, followed by 8 to 12 weeks of oral prednisolone. Total bilirubin (TB) levels (3, 6, and 12 months after surgery), early onset of cholangitis, and two-year native liver survival were evaluated. Results. 53.4%, 56.9%, and 58.1% of the patients in the high-dose steroid group were jaundice-free 3, 6, and 12 months after surgery, respectively; these values were significantly higher than the 38.7%, 39.4%, and 43.3% of the low-dose steroid group. One year after surgery, the incidence of cholangitis in the high-dose group (32.0%) was lower than that in the low-dose group (48.0%). Infants with native liver in the high-dose group had a better two-year survival compared to those in the low-dose steroid group (53.7% versus 42.6%). Conclusions. The high-dose steroid protocol can reduce the incidence of cholangitis, increase the jaundice-free rate, and improve two-year survival with native liver after the Kasai operation.
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spelling pubmed-38579022013-12-17 Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid Dong, Rui Song, Zai Chen, Gong Zheng, Shan Xiao, Xian-min Gastroenterol Res Pract Clinical Study Objective. The dosage, duration, and the benefits of high-dose steroid treatment and outcome in biliary atresia (BA) remain controversial. In this study, we evaluated the impact of high-dose steroid therapy on the outcome of BA after the Kasai procedure. Methods. Intravenous prednisolone administration was started 1 week after surgery, followed by 8 to 12 weeks of oral prednisolone. Total bilirubin (TB) levels (3, 6, and 12 months after surgery), early onset of cholangitis, and two-year native liver survival were evaluated. Results. 53.4%, 56.9%, and 58.1% of the patients in the high-dose steroid group were jaundice-free 3, 6, and 12 months after surgery, respectively; these values were significantly higher than the 38.7%, 39.4%, and 43.3% of the low-dose steroid group. One year after surgery, the incidence of cholangitis in the high-dose group (32.0%) was lower than that in the low-dose group (48.0%). Infants with native liver in the high-dose group had a better two-year survival compared to those in the low-dose steroid group (53.7% versus 42.6%). Conclusions. The high-dose steroid protocol can reduce the incidence of cholangitis, increase the jaundice-free rate, and improve two-year survival with native liver after the Kasai operation. Hindawi Publishing Corporation 2013 2013-11-24 /pmc/articles/PMC3857902/ /pubmed/24348545 http://dx.doi.org/10.1155/2013/902431 Text en Copyright © 2013 Rui Dong et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Dong, Rui
Song, Zai
Chen, Gong
Zheng, Shan
Xiao, Xian-min
Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid
title Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid
title_full Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid
title_fullStr Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid
title_full_unstemmed Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid
title_short Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid
title_sort improved outcome of biliary atresia with postoperative high-dose steroid
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857902/
https://www.ncbi.nlm.nih.gov/pubmed/24348545
http://dx.doi.org/10.1155/2013/902431
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