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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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 ORIGINAL ARTICLE
Year : 2019  |  Volume : 24  |  Issue : 3  |  Page : 185-188

Early cholangitis after portoenterostomy in children with biliary atresia


1 Department of Pediatric Surgery, CHILDS Trust Medical Research Foundation, Kanchi Kamakoti Childs Trust Hospital; Department of Liver Surgery and Transplantation, Institute of Liver Diseases and Transplantation, Gleneagles Global Health City, Chennai, Tamil Nadu, India
2 Department of Liver Surgery and Transplantation, Institute of Liver Diseases and Transplantation, Gleneagles Global Health City, Chennai, Tamil Nadu, India
3 Department of Pediatric Surgery, CHILDS Trust Medical Research Foundation, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Priya Ramachandran
No. 10, Nageswara Road, Nungambakkam, Chennai - 600 038, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaps.JIAPS_96_18

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Aims and Objectives: Biliary atresia (BA) is a cholangiodestructive disease of the biliary tree. The first line of treatment is a Kasai portoenterostomy (PE) following which patients may develop cholangitis. We studied the effect of early cholangitis on the outcome of PE, namely jaundice clearance and early native liver survival (NLS). Methods: We reviewed the data of all children who developed cholangitis after PE from our prospectively maintained database of children with BA. The standardized treatment of all children in the database is described. The frequency and nature of these episodes were characterized, and the outcome of PE and NLS 1 year after PE was calculated. Results: Of 62 children who underwent PE in our institutions, 27 developed cholangitis. All episodes of cholangitis occurred within 14 months of PE. Of 25 children who cleared jaundice in the overall series, 19 had cholangitis. The incidence of cholangitis was significantly higher in children who cleared jaundice. Nine children who had cholangitis are alive with native livers for more than 1 year after PE. Twelve children had intractable cholangitis. Three of these children are alive with native liver 1 year after PE. Conclusion: In our series, cholangitis occurred in most children who cleared jaundice. Furthermore, the 1-year NLS of children who developed cholangitis was 33%.






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  2005 - Journal of Indian Association of Pediatric Surgeons | Published by Wolters Kluwer - Medknow 

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