Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2022; 14(1): 56-63
Published online Jan 27, 2022. doi: 10.4240/wjgs.v14.i1.56
Laparoscopic Kasai portoenterostomy can be a standard surgical procedure for treatment of biliary atresia
Chiyoe Shirota, Akinari Hinoki, Takahisa Tainaka, Wataru Sumida, Fumie Kinoshita, Kazuki Yokota, Satoshi Makita, Hizuru Amano, Yoichi Nakagawa, Hiroo Uchida
Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Kazuki Yokota, Satoshi Makita, Hizuru Amano, Yoichi Nakagawa, Hiroo Uchida, Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya 4668550, Aichi, Japan
Akinari Hinoki, Rare/Intractable Cancer Analysis Research, Nagoya University Graduate School of Medicine, Nagoya 4668550, Aichi, Japan
Fumie Kinoshita, Department of Advanced Medicine, Nagoya University Hospital, Nagoya 466-8560, Aichi, Japan
Author contributions: Shirota C, Tainaka T, Sumida W, Yokota K, and Makita S collected the patient data; Shirota C and Hinoki A analyzed patient images; Hinoki A and Nakagawa Y interpreted the patient data regarding operation; Kinoshita F analyzed the statistics; Shirota C and Uchida H were main contributors in writing the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the (Nagoya University Hospital) Institutional Review Board (Approval No. 2020-0593).
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Hiroo Uchida, MD, PhD, Doctor, Professor, Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Syowa-ku, Nagoya 4668550, Aichi, Japan.
Received: April 5, 2021
Peer-review started: April 5, 2021
First decision: July 3, 2021
Revised: July 31, 2021
Accepted: January 13, 2022
Article in press: January 13, 2022
Published online: January 27, 2022
Research background

The application of laparoscopic portoenterostomy (LapPE) as a treatment option for BA remains controversial.

Research motivation

Management after BA surgeries is complicated and requires a centralized procedure for consistency. Thus, it is considered important to perform a largescale assessment at a single facility with a centralized management procedure for adequate comparison in the outcomes between LapPE and OpenPE.

Research objectives

The aim of this study was to compare the outcomes of Lap-PE with those of laparotomy (Open-PE) at our single institution.

Research methods

The surgical outcomes of PE were retrospectively analyzed for patients with a non-correctable type of BA from 2003 to 2020.

Research results

Throughout the assessment period, 119 patients received PE for BA treatment, including 66 Open-PE and 53 Lap-PE cases. Although the operation duration was longer (medians: for Open-PE, 242 min; for Lap-PE, 341 min; P < 0.001), blood loss was considerably less (medians: for Open-PE, 52 mL; for Lap-PE, 24 mL; P < 0.001) in the Lap-PE group than in the Open-PE group. Native liver survival rates were > 80% for both groups for the first half year post surgery, followed by a gradual decrease with time; there were no statistically significant differences in the native liver survival rates for any durations assessed.

Research conclusions

Lap-PE could be a standard therapy for BA.

Research perspectives

The rate of complications did not differ significantly, but long-term survival rates may differ. Therefore, further studies with a larger study size, longterm follow-up, and thorough evaluations are warranted.