Laparoscopic Kasai portoenterostomy for cystic biliary atresia: midterm follow-up results of 35 patients

Purpose To investigate the clinical characteristics of cystic biliary atresia (CBA) and evaluate the midterm follow-up outcomes after laparoscopic treatment. Methods We analyzed and compared data retrospectively on CBA patients (group A) and nonsyndromic type III biliary atresia (BA) patients (group B), who underwent laparoscopic Kasai portoenterostomy (LKPE) during the same period. Results There were no significant differences in operative time, conversion rate, or the incidence of any postoperative complications between groups A and B ( P > 0.05). The mean age at surgery ( P < 0.01), rates of clearance of jaundice (CJ), cholangitis ( P < 0.05), and 5-year survival with a native liver (SNL) were significantly lower in group A than in group B. Among the 35 patients with CBA, the CJ and 5-year SNL rates were significantly better in those with type I ( n = 27) than in those with type IIId ( n = 8) ( P < 0.05). Conclusions LKPE is a feasible and safe procedure for CBA. The 5-year SNL after LKPE was better in patients with CBA than in those with nonsyndromic type III BA. The 5-year SNL after LKPE for type I CBA was better than that for type IIId CBA.