Factors influencing outcome after hepatic portoenterostomy for biliary atresia: a logistic regression analysis.

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dc.contributor.authorChittmittrapap, Soottipornen_US
dc.contributor.authorChandrakamol, Bidhyaen_US
dc.contributor.authorPoovorawan, Yongen_US
dc.contributor.authorSuwangool, Pongsepeeraen_US
dc.date.accessioned2009-05-27T18:26:13Z
dc.date.available2009-05-27T18:26:13Z
dc.date.issued2005-08-13en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractBACKGROUND/OBJECTIVE: The association of many factors with the outcome in Biliary atresia (BA) after hepatic portoenterostomy has drawn the attention of many pediatric hepatologists and hepatobiliary surgeons. Understanding these factors will become an important subject in prediction of the postoperative status and in indicating further proper management. MATERIAL AND METHOD: During the last 9 years, 159 BA babies were treated by hepatic portoenterostomy. The authors reviewed the following factors and how they related to outcome: age at operation, total bilirubin (TB) level, type of BA, postoperative bile drainage, hepatic histological features at operation, preoperative and postoperative cholangitis. A multiple logistic regression analysis was used to indicate the factors which significantly influenced the outcome. RESULTS: Of the 159 BA babies, clearing of jaundice confirmed by the color of stool and postoperative serum bilirubin level less than 2 mg % was observed in 54 patients (Group A). Bile drainage with mild jaundice (TB 2-5 mg %) was detected in 65 patients (Group B). The operation failed to create bile flow clinically and biochemically in 40 patients (Group C). Some patients in the last group died during follow-up due to hepatic disease. The multiple logistic regression analysis revealed that the age at operation (> 8 weeks of age), and the presence of portal and parenchymal inflammation at operation significantly related to the failure of portoenterostomy which was followed by portal hypertension with or without esophageal varices. The presence of cholangitis was also significantly related to a poor outcome. CONCLUSION: The age at operation, portal and parenchymal inflammation and the presence of cholangitis are significant factors which relate to the poor prognosis of BA. Recognition of these will lead to proper long-term management.en_US
dc.description.affiliationDivision of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.en_US
dc.identifier.citationChittmittrapap S, Chandrakamol B, Poovorawan Y, Suwangool P. Factors influencing outcome after hepatic portoenterostomy for biliary atresia: a logistic regression analysis. Journal of the Medical Association of Thailand. 2005 Aug; 88(8): 1077-82en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/39142
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshAge Factorsen_US
dc.subject.meshBiliary Atresia --complicationsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshLiver Cirrhosis --complicationsen_US
dc.subject.meshLiver Function Testsen_US
dc.subject.meshLogistic Modelsen_US
dc.subject.meshMaleen_US
dc.subject.meshOutcome Assessment (Health Care)en_US
dc.subject.meshPortoenterostomy, Hepaticen_US
dc.subject.meshPredictive Value of Testsen_US
dc.subject.meshProbabilityen_US
dc.subject.meshPrognosisen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshRisk Factorsen_US
dc.titleFactors influencing outcome after hepatic portoenterostomy for biliary atresia: a logistic regression analysis.en_US
dc.typeJournal Articleen_US
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