Analysis of Cholangitis Rates with Extended Perioperative Antibiotics and Adjuvant Corticosteroids in Biliary Atresia

Lynette Goh; Kong Boo Phua; Yee Low; Li Wei Chiang; Chen Yong; Fang Kuan Chiou

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자료유형: 학술저널

저자정보: Lynette Goh (KK Women's and Children's Hospital) Kong Boo Phua (KK Women's and Children's Hospital) Yee Low (KK Women's and Children's Hospital) Li Wei Chiang (KK Women's and Children's Hospital) Chen Yong (KK Women's and Children's Hospital) Fang Kuan Chiou (KK Women's and Children's Hospital)

저널정보: 대한소아소화기영양학회 Pediatric Gastroenterology, Hepatology & Nutrition Pediatric Gastroenterology, Hepatology & Nutrition 제24권 제4호

발행연도: 2021.1

수록면: 366 - 376 (11page)

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Purpose: There is no consensus regarding adjuvant therapies following Kasai portoenterostomy (KP) for biliary atresia (BA). This study aimed to analyze the effect of extended perioperative intravenous antibiotics (PI-Abx) and adjuvant corticosteroid on cholangitis and jaundice clearance rates in the 3 years post-KP in children with BA. Methods: Data of patients who underwent KP between 1999-2018 at a single center were retrospectively analyzed. Group A (1999?2010) received PI-Abx for 5 days, Group B (2010?2012) received PI-Abx for 5 days plus low-dose prednisolone (2 mg/kg), and Group C (2012?2017) received PI-Abx for 14 days plus high-dose prednisolone (5 mg/kg). Results: Fifty-four patients were included with groups A, B, and C comprising 25, 9, and 20 patients, respectively. The number of episodes of cholangitis was 1.0, 1.6, and 1.3 per patient (p=NS) within the first year and 1.8, 2.3, and 1.7 (p=NS) over 3 years in Groups A, B, and C, respectively. The jaundice clearance rate at 6 months was 52%, 78%, and 50% (p=NS), and the 3-year native liver survival (NLS) rate was 76%, 100%, and 80% (p=NS) in Groups A, B, and C, respectively. A near-significant association was observed between the incidence of cholangitis within the first year and decompensated liver cirrhosis/death at 3 years post KP (p=0.09). Persistence of jaundice at 6 months was significantly associated with decompensated cirrhosis/death at 3 years (p<0.001). Conclusion: The extended duration of PI-Abx and adjuvant corticosteroids was not associated with improved rates of cholangitis, jaundice clearance, or NLS in patients with BA.

#Biliary atresia #Cholangitis #Cirrhosis #Antibiotics #Corticosteroids

참고문헌 (2)

참고문헌 신청

Ryckman FC / 1998 / Biliary atresia--surgical management and treatment options as they relate to outcome / Liver Transpl Surg 4(5 Suppl 1):S24~S33

McDiarmid SV / 2004 / Selection of pediatric candidates under the PELD system / Liver Transpl 10(10 Suppl 2):S23~S30

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