Laparoscopic Kasai portoenterostomy can be a standard surgical procedure for treatment of biliary atresia

BACKGROUND Biliary atresia(BA)is a rare pediatric disease.AIM To compare the outcomes of laparoscopic portoenterostomy(Lap-PE)with those of laparotomy(Open-PE)at a single institution.METHODS The surgical outcomes of PE were retrospectively analyzed for patients with a non-correctable type of BA from 2003 to 2020.RESULTS Throughout the assessment period,119 patients received PE for BA treatment,including 66 Open-PE and 53 Lap-PE cases.Although the operation duration was longer(medians:for Open-PE,242 min;for Lap-PE,341 min;P<0.001),blood loss was considerably less(medians:for Open-PE,52 mL;for Lap-PE,24 mL;P<0.001)in the Lap-PE group than in the Open-PE group.The postoperative recovery of the Lap-PE group was more favorable;specifically,both times to resume oral intake and drain removal were significantly shorter in the Lap-PE group.Complete resolution of jaundice was observed in 45 Open-PE cases and 42 Lap-PE cases,with no statistically significant difference(P=0.176).Native liver survival rates were>80%for both groups for the first half year post surgery,followed by a gradual decrease with time;there were no statistically significant differences in the native liver survival rates for any durations assessed.CONCLUSION Lap-PE could be a standard therapy for BA.