When a Kasai portoenterostomy goes wrong

The first job Archivist had in paediatrics was working as an SHO on the gastroenterology ward in a children’s hospital in Manchester. There were rows of children with biliary atresia, small for their age, jaundiced with large swollen abdomens usually post Kasai portoenterostomy (KPE) or a few waiting to go for surgery. Pale white stools, once seen, will never be forgotten. Post-surgery, we were waiting for the jaundice to clear a sign of success and a failed Kasai operation meant liver transplant. The first liver transplant in children was in 1963 which was unfortunately unsuccessful. Fortunately, now, graft and patient survival rates are well over 90% at 1, 5 and 10 years post-surgery. Our main concern was of ascending cholangitis and we continually looked for fever and altered LFTs and had a low threshold for starting intra venous antibiotics. What are the reasons for failure of KPE? Matkovici M...
Source: Archives of Disease in Childhood - Category: Pediatrics Tags: Miscellanea Source Type: research