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Laparoscopic versus open Kasai procedure for biliary atresia: long-term results of a randomized clinical trial

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Abstract

Purpose

The role of the laparoscopic approach for the Kasai procedure in the management of biliary atresia is still controversial. The aim of this study is to compare the long-term results of the laparoscopic Kasai procedure (LKP) to the open Kasai procedure (OKP).

Methods

A randomized clinical trial was carried out from October 2009 to March 2017. Patients diagnosed with biliary atresia type III were randomized into 2 groups: one group underwent LKP and the other group–OKP. All the surgical procedures were performed by the same surgeon with the same technical principles. The long-term outcomes were compared between the two groups.

Results

61 patients underwent LKP and 61 patients–OKP, with a median age at the surgery of 79.7 days. The two groups had no significant differences regarding the patients’ baseline characteristics. At follow-up up to 142 months, the jaundice-free rate at the 6th postoperative month for LKP and OKP was 52.5% and 60.7%, respectively (p = 0.23). The 10-year cumulative survival after LKP tended to be inferior to OKP, respectively 44.3% vs. 58.9% (p = 0.09).

Conclusions

In this study, the long-term results of LKP tended to be inferior compared to OKP although the differences were not significant.

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Data availability

The conclusion was based on the data already presented in the previous part of the article.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Saint Paul Hospital, No 12 Chu Van An Street, Ba Dinh District, Hanoi, 100000, Vietnam

    Tran N. Son & Duong V. Mai

  2. Department of Surgery, National Children Hospital, Hanoi, Vietnam

    Tran N. Son, Pham T. Tung & Nguyen T. Liem

  3. Vinmec International Hospital, Hanoi, Vietnam

    Nguyen T. Liem

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  1. Tran N. Son
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  2. Duong V. Mai
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  4. Nguyen T. Liem
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Contributions

LNT designed the study STN and MDV wrote the main manuscript text TPT and MDV collected the data STN edited and revised the manuscript All authors reviewed the manuscript.

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Correspondence to Tran N. Son.

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Son, T.N., Mai, D.V., Tung, P.T. et al. Laparoscopic versus open Kasai procedure for biliary atresia: long-term results of a randomized clinical trial. Pediatr Surg Int 39, 111 (2023). https://doi.org/10.1007/s00383-023-05391-4

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  • DOI: https://doi.org/10.1007/s00383-023-05391-4

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