Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid
Objective. The dosage, duration, and the benefits of high-dose steroid treatment and outcome in biliary atresia (BA) remain controversial. In this study, we evaluated the impact of high-dose steroid therapy on the outcome of BA after the Kasai procedure. Methods. Intravenous prednisolone administrat...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2013/902431 |
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| author | Rui Dong Zai Song Gong Chen Shan Zheng Xian-min Xiao |
| author_facet | Rui Dong Zai Song Gong Chen Shan Zheng Xian-min Xiao |
| author_sort | Rui Dong |
| collection | DOAJ |
| description | Objective. The dosage, duration, and the benefits of high-dose steroid treatment and outcome in biliary atresia (BA) remain controversial. In this study, we evaluated the impact of high-dose steroid therapy on the outcome of BA after the Kasai procedure. Methods. Intravenous prednisolone administration was started 1 week after surgery, followed by 8 to 12 weeks of oral prednisolone. Total bilirubin (TB) levels (3, 6, and 12 months after surgery), early onset of cholangitis, and two-year native liver survival were evaluated. Results. 53.4%, 56.9%, and 58.1% of the patients in the high-dose steroid group were jaundice-free 3, 6, and 12 months after surgery, respectively; these values were significantly higher than the 38.7%, 39.4%, and 43.3% of the low-dose steroid group. One year after surgery, the incidence of cholangitis in the high-dose group (32.0%) was lower than that in the low-dose group (48.0%). Infants with native liver in the high-dose group had a better two-year survival compared to those in the low-dose steroid group (53.7% versus 42.6%). Conclusions. The high-dose steroid protocol can reduce the incidence of cholangitis, increase the jaundice-free rate, and improve two-year survival with native liver after the Kasai operation. |
| format | Article |
| id | doaj-art-b13402abf3294c6ea1dcccef468457ee |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-b13402abf3294c6ea1dcccef468457ee2025-02-03T05:44:54ZengWileyGastroenterology Research and Practice1687-61211687-630X2013-01-01201310.1155/2013/902431902431Improved Outcome of Biliary Atresia with Postoperative High-Dose SteroidRui Dong0Zai Song1Gong Chen2Shan Zheng3Xian-min Xiao4Department of Pediatric Surgery, Children’s Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, ChinaDepartment of Pediatric Surgery, Children’s Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, ChinaDepartment of Pediatric Surgery, Children’s Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, ChinaDepartment of Pediatric Surgery, Children’s Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, ChinaDepartment of Pediatric Surgery, Children’s Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of Health, 399 Wan Yuan Road, Shanghai 201102, ChinaObjective. The dosage, duration, and the benefits of high-dose steroid treatment and outcome in biliary atresia (BA) remain controversial. In this study, we evaluated the impact of high-dose steroid therapy on the outcome of BA after the Kasai procedure. Methods. Intravenous prednisolone administration was started 1 week after surgery, followed by 8 to 12 weeks of oral prednisolone. Total bilirubin (TB) levels (3, 6, and 12 months after surgery), early onset of cholangitis, and two-year native liver survival were evaluated. Results. 53.4%, 56.9%, and 58.1% of the patients in the high-dose steroid group were jaundice-free 3, 6, and 12 months after surgery, respectively; these values were significantly higher than the 38.7%, 39.4%, and 43.3% of the low-dose steroid group. One year after surgery, the incidence of cholangitis in the high-dose group (32.0%) was lower than that in the low-dose group (48.0%). Infants with native liver in the high-dose group had a better two-year survival compared to those in the low-dose steroid group (53.7% versus 42.6%). Conclusions. The high-dose steroid protocol can reduce the incidence of cholangitis, increase the jaundice-free rate, and improve two-year survival with native liver after the Kasai operation.http://dx.doi.org/10.1155/2013/902431 |
| spellingShingle | Rui Dong Zai Song Gong Chen Shan Zheng Xian-min Xiao Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid Gastroenterology Research and Practice |
| title | Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid |
| title_full | Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid |
| title_fullStr | Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid |
| title_full_unstemmed | Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid |
| title_short | Improved Outcome of Biliary Atresia with Postoperative High-Dose Steroid |
| title_sort | improved outcome of biliary atresia with postoperative high dose steroid |
| url | http://dx.doi.org/10.1155/2013/902431 |
| work_keys_str_mv | AT ruidong improvedoutcomeofbiliaryatresiawithpostoperativehighdosesteroid AT zaisong improvedoutcomeofbiliaryatresiawithpostoperativehighdosesteroid AT gongchen improvedoutcomeofbiliaryatresiawithpostoperativehighdosesteroid AT shanzheng improvedoutcomeofbiliaryatresiawithpostoperativehighdosesteroid AT xianminxiao improvedoutcomeofbiliaryatresiawithpostoperativehighdosesteroid |