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World J Gastrointest Surg. Mar 27, 2026; 18(3): 115497
Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.115497
Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.115497
Impact of early postoperative pain management strategies on complication rates in infants with biliary atresia after Kasai portoenterostomy
Zhi-Jun Yan, Department of Anesthesiology, The First Affiliated Hospital of University of South China, Hengyang 421001, Hunan Province, China
Xiao-Hua Guo, Zi-Xia Huang, Jie Huang, Department of Anesthesiology, Guangzhou Women and Children’s Medical Center, Guangzhou 510623, Guangdong Province, China
Wen-Jie Liu, Department of Anesthesiology, The Second Affiliated Hospital of University of South China, Hengyang 421001, Hunan Province, China
Author contributions: Yan ZJ designed the study; Guo XH, Huang ZX, Huang J responsible for research methodology design, formal analysis, investigation, data curation, and writing the original draft; Guo XH, Huang ZX, Huang J, and Liu WJ responsible for study conceptualization; Liu WJ responsible for resource provision, supervision, manuscript review and editing, and project administration. All authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of The First Affiliated Hospital of University of South China.
Clinical trial registration statement: This study is a randomized controlled trial. Based on the characteristics of the research design and the scope of clinical activities involved, the study was not registered with the Clinical Trial Registry prior to its initiation.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: No additional data are available.
Corresponding author: Wen-Jie Liu, MD, Associate Chief Physician, Department of Anesthesiology, The Second Affiliated Hospital of University of South China, No. 30 Jiefang Road, Shigu District, Hengyang 421001, Hunan Province, China. wenjieliu96@163.com
Received: November 7, 2025
Revised: December 12, 2025
Accepted: January 22, 2026
Published online: March 27, 2026
Processing time: 140 Days and 3.2 Hours
Revised: December 12, 2025
Accepted: January 22, 2026
Published online: March 27, 2026
Processing time: 140 Days and 3.2 Hours
Core Tip
Core Tip: This study demonstrates that an early multimodal analgesia protocol, utilizing ultrasound-guided transversus abdominis plane block combined with patient-controlled intravenous analgesia, is superior to conventional on-demand opioid analgesia for infants after Kasai surgery. This approach not only provides superior and safer pain control but is also associated with reduced postoperative complications (particularly cholangitis and pulmonary infection), faster recovery, and significantly improved 6-month native liver survival.