Survival analysis after Kasai procedure in 132 children with biliary atresia

Abstract:

Objective：To analyze the survival rate and the risk factors in patients with biliary atresia（BA） who underwent portoen－terostomy（Kasai） procedure. Methods：Totally 132 patients with biliary atresia who underwent Kasai procedure from Janunary 2007 to Janunary 2014 were recruited to this study. Data including age for Kasai procedure，presence of cirrhosis at the time of operation，use of steroids after operation and CMV infection were input in SPSS 19.0. Survival rates of the patients were calculated by life table. Kaplan-Meier method and COX proportional hazards model were used to analyze the suspected risk factors of survival. Results：During the 7-year follow up，35 survived and 97 were dead among all 132 subjects. The median follow up time of survival patients were 53.3（from 12 to 86.17） months. one-，two- and five-year survival rate were （32.0±6.0）%，（26.0±4.0）% and （24.0±4.0）% respec－tively. The survival rates for use of steroids after Kasai procedure or not were 43.9% vs 18.7%（P=0.027）. While the survival rates of cirrhosis at the time of the Kasai procedure or not were 18.9% vs. 36.2%（P=0.037）. Steroid and cirrhosis were regarded as main af－fecting factors for survival rate according to Kaplan-Meier method. However，only the usage of steroid was the solo independent risk factor for survival rates after Kasai procedure by COX proportional hazards model（RR=0.602，95%CI=0.377 to 0.964，P=0.034）. Conclusion：Kasai procedure is an effective treatment for pa－tients with BA，and proper usage of steroids after Kasai opera－tion seems to be one of the important treatments to elevate the survival rate.