Published online Jan 27, 2022. doi: 10.4240/wjgs.v14.i1.56
Peer-review started: April 5, 2021
First decision: July 3, 2021
Revised: July 31, 2021
Accepted: January 13, 2022
Article in press: January 13, 2022
Published online: January 27, 2022
Processing time: 288 Days and 23 Hours
Biliary atresia (BA) is a rare pediatric disease.
To compare the outcomes of laparoscopic portoenterostomy (Lap-PE) with those of laparotomy (Open-PE) at a single institution.
The surgical outcomes of PE were retrospectively analyzed for patients with a non-correctable type of BA from 2003 to 2020.
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.
Lap-PE could be a standard therapy for BA.
Core Tip: The aim of this study was to compare the outcomes of laparoscopic portoenterostomy (Lap-PE) with those of laparotomy (Open-PE) at our single institution. Although the surgical operating time was longer, the lower blood loss and more favorable postsurgical recovery (shorter time to resume oral intake and time to drain removal as well as less postsurgical adhesion) were significant advantages of Lap-PE over Open-PE. There was no significant difference in native liver survival rates or short-term surgical outcomes between LapPE and OpenPE. Therefore, our study results support the efficacy of Lap-PE as a standard therapy.