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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2013
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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. |
format | Online Article Text |
id | pubmed-3857902 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
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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