SynthesisPediatric surgery international2016
Steroids after the Kasai procedure for biliary atresia: the effect of age at Kasai portoenterostomy.
Synthesis in Pediatric surgery international, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.
- Glucocorticosteroids for infants with biliary atresia following Kasai portoenterostomy.The Cochrane database of systematic reviews · 2018Pooled it
- Successful surgical intervention and management of biliary atresia in a 4-month-old infant: a case report.International journal of surgery case reports · 2026Article
- Efficacy and safety of post-Kasai steroid-based protocol in biliary atresia.Journal of pediatric gastroenterology and nutrition · 2026Article
- A national database study of adjuvant steroids following Kasai portoenterostomy for biliary atresia.Pediatric surgery international · 2026Article
- Taurocholic acid induces intrahepatic cholangiocyte cell proliferation via activating NRAS and YAP1.PloS one · 2026Article
- Rectal budesonide: A potential game changer after Kasai hepatoportoenterostomy.Journal of pediatric gastroenterology and nutrition · 2025Article
- A nomogram model based on routine serum markers for predicting the occurrence of primary cholangitis after Kasai operation for biliary atresia.Translational pediatrics · 2025Article
- Biliary atresia.Nature reviews. Disease primers · 2024Review
- Proteomics Defines Plasma Biomarkers for the Early Diagnosis of Biliary Atresia.Journal of proteome research · 2024Article
- A fetal wound healing program after intrauterine bile duct injury may contribute to biliary atresia.Journal of hepatology · 2023Article
- Prednisolone administration monitored by postoperative stool color achieves high jaundice clearance after laparoscopic portoenterostomy for biliary atresia.Pediatric surgery international · 2023Article
- Customized Postoperative Therapy Improves Bile Drainage in Biliary Atresia: A Single Center Preliminary Report.Journal of pediatric surgery · 2023Article
- Letter to the Editor: Comment on Wickramasekara N, Ignatius J, Lamahewage A. Prognostic factors and outcomes of Kasai portoenterostomy (KPE): nine-year experience from a lower-middle income country. Pediatr Surg Int. 2023; 39(1):142. doi: 10.1007/s00383-023-05,424-y.Pediatric surgery international · 2023Article
- A multi-disciplinary, comprehensive approach to management of children with heterotaxy.Orphanet journal of rare diseases · 2022Review
- Cholangitis Definition and Treatment after Kasai Hepatoportoenterostomy for Biliary Atresia: A Delphi Process and International Expert Panel.Journal of clinical medicine · 2022Article
- A Novel Model for Predicting the Clearance of Jaundice in Patients With Biliary Atresia After Kasai Procedure.Frontiers in pediatrics · 2022Article
- Comparative analysis of cystic biliary atresia and choledochal cysts.Frontiers in pediatrics · 2022Article
- Omphalocele and biliary atresia: chance or causality. A case report.Einstein (Sao Paulo, Brazil) · 2022Article
- A nomogram model based on preoperative grey-scale US features and routine serum biomarkers to predict the outcome of infants with biliary atresia after Kasai portoenterostomy.Frontiers in pediatrics · 2022Article
- Biological and Histological Assessment of the Hepatoportoenterostomy Role in Biliary Atresia as a Stand-Alone Procedure or as a Bridge toward Liver Transplantation.Medicina (Kaunas, Lithuania) · 2020Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The use of adjuvant steroids following Kasai porteoenterostomy (KPE) for biliary atresia is controversial. The aim of this study was twofold: a systematic review of published literature and an update of the clinical Kings College Hospital series to look for evidence of an effect of age on the outcome in a group of BA infants treated with high-dose steroids. This clinical study included infants treated between January 2006 and June 2014 who underwent KPE by day 70 of life and who received high-dose steroids (oral prednisolone starting 5 mg/kg/day). They were subdivided into cohorts according to age at which KPE was performed. The outcome measured was clearance of jaundice (<20 µmol/L) by 6 months and native liver survival. R × C χ(2) analysis and log-rank tests were used, respectively, and P ≤ 0.05 was regarded as significant. 104 infants were included with a median age at KPE of 45 (range 12-70) days. 71/104 (67 %) cleared their jaundice by 6 months of age. Age-cohort analysis showed a trend (P = 0.03) favouring early KPE (e.g. 100 % of 11 infants operated on <30 days clearing their jaundice compared to 66 % of those operated on between 61 and 70 days). There was a significant native liver survival benefit for those operated on <45 days (5 year NLS estimate 69 versus 46 %; P = 0.05). Clearance of jaundice is related to the age at KPE in infants who receive high-dose steroids. Native liver survival appears to be improved as a result of this. This is the first study to show tangible longer-term benefit from high-dose steroids in biliary atresia.
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