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Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation

PURPOSE: This study aimed to investigate the negative effects of intestinal obstruction for jaundice-free native liver survival after Kasai portoenterostomy (PE) for biliary atresia (BA). METHODS: We retrospectively reviewed the records of patients who underwent PE for BA between 2006 and 2019. We e...

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Autores principales: Takimoto, Aitaro, Sumida, Wataru, Amano, Hizuru, Shirota, Chiyoe, Tainaka, Takahisa, Yokota, Kazuki, Makita, Satoshi, Yasui, Akihiro, Kanou, Yoko, Hinoki, Akinari, Uchida, Hiroo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847427/
https://www.ncbi.nlm.nih.gov/pubmed/33388958
http://dx.doi.org/10.1007/s00383-020-04807-9
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author Takimoto, Aitaro
Sumida, Wataru
Amano, Hizuru
Shirota, Chiyoe
Tainaka, Takahisa
Yokota, Kazuki
Makita, Satoshi
Yasui, Akihiro
Kanou, Yoko
Hinoki, Akinari
Uchida, Hiroo
author_facet Takimoto, Aitaro
Sumida, Wataru
Amano, Hizuru
Shirota, Chiyoe
Tainaka, Takahisa
Yokota, Kazuki
Makita, Satoshi
Yasui, Akihiro
Kanou, Yoko
Hinoki, Akinari
Uchida, Hiroo
author_sort Takimoto, Aitaro
collection PubMed
description PURPOSE: This study aimed to investigate the negative effects of intestinal obstruction for jaundice-free native liver survival after Kasai portoenterostomy (PE) for biliary atresia (BA). METHODS: We retrospectively reviewed the records of patients who underwent PE for BA between 2006 and 2019. We evaluated the postoperative morbidity of intestinal obstruction for up to 2 years after PE and the effects of intestinal obstruction on jaundice-free native liver survival. On the basis of their initial operation, patients were divided into open portoenterostomy (Open-PE) and laparoscopic portoenterostomy (Lap-PE) groups, and morbidity was compared. RESULTS: Of the 87 patients reviewed, 6 (6.9%) patients developed postoperative intestinal obstruction and underwent surgery to relieve the obstruction. The morbidity of early postoperative intestinal obstruction was 1.68 per 10,000 person days. The jaundice-free native liver survival rate among patients who once achieved jaundice-free status after PE was significantly lower in the patients with intestinal obstruction compared to in those without intestinal obstruction (0% vs. 73.8%; RR = 3.81, p = 0.007). No significant differences were seen in postoperative intestinal obstructions between the Open-PE and Lap-PE groups (p = 0.242). CONCLUSIONS: Intestinal obstruction negatively impact jaundice-free native liver survival, even in patients who once achieved jaundice-free status after PE for BA.
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spelling pubmed-78474272021-02-08 Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation Takimoto, Aitaro Sumida, Wataru Amano, Hizuru Shirota, Chiyoe Tainaka, Takahisa Yokota, Kazuki Makita, Satoshi Yasui, Akihiro Kanou, Yoko Hinoki, Akinari Uchida, Hiroo Pediatr Surg Int Original Article PURPOSE: This study aimed to investigate the negative effects of intestinal obstruction for jaundice-free native liver survival after Kasai portoenterostomy (PE) for biliary atresia (BA). METHODS: We retrospectively reviewed the records of patients who underwent PE for BA between 2006 and 2019. We evaluated the postoperative morbidity of intestinal obstruction for up to 2 years after PE and the effects of intestinal obstruction on jaundice-free native liver survival. On the basis of their initial operation, patients were divided into open portoenterostomy (Open-PE) and laparoscopic portoenterostomy (Lap-PE) groups, and morbidity was compared. RESULTS: Of the 87 patients reviewed, 6 (6.9%) patients developed postoperative intestinal obstruction and underwent surgery to relieve the obstruction. The morbidity of early postoperative intestinal obstruction was 1.68 per 10,000 person days. The jaundice-free native liver survival rate among patients who once achieved jaundice-free status after PE was significantly lower in the patients with intestinal obstruction compared to in those without intestinal obstruction (0% vs. 73.8%; RR = 3.81, p = 0.007). No significant differences were seen in postoperative intestinal obstructions between the Open-PE and Lap-PE groups (p = 0.242). CONCLUSIONS: Intestinal obstruction negatively impact jaundice-free native liver survival, even in patients who once achieved jaundice-free status after PE for BA. Springer Berlin Heidelberg 2021-01-03 2021 /pmc/articles/PMC7847427/ /pubmed/33388958 http://dx.doi.org/10.1007/s00383-020-04807-9 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
Takimoto, Aitaro
Sumida, Wataru
Amano, Hizuru
Shirota, Chiyoe
Tainaka, Takahisa
Yokota, Kazuki
Makita, Satoshi
Yasui, Akihiro
Kanou, Yoko
Hinoki, Akinari
Uchida, Hiroo
Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation
title Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation
title_full Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation
title_fullStr Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation
title_full_unstemmed Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation
title_short Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation
title_sort postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847427/
https://www.ncbi.nlm.nih.gov/pubmed/33388958
http://dx.doi.org/10.1007/s00383-020-04807-9
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